A Combined Pulmonary-Radiology Workshop for Visual Evaluation of COPD: Study Design, Chest CT Findings and Concordance with Quantitative Evaluation

被引：138

作者：

Barr, R. Graham ^{[1
]}

Berkowitz, Eugene A. ^{[1
]}

Bigazzi, Francesca ^{[1
]}

Bode, Frederick ^{[1
]}

Bon, Jessica ^{[1
]}

Bowler, Russell P. ^{[1
]}

Chiles, Caroline ^{[1
]}

Crapo, James D. ^{[1
]}

Criner, Gerard J. ^{[1
]}

Curtis, Jeffrey L. ^{[1
]}

Dass, Chandra ^{[1
]}

Dirksen, Asger ^{[1
]}

Dransfield, Mark T. ^{[1
]}

Edula, Goutham ^{[1
]}

Erikkson, Leif ^{[1
]}

Friedlander, Adam ^{[1
]}

Galperin-Aizenberg, Maya ^{[1
]}

Gefter, Warren B. ^{[1
]}

Gierada, David S. ^{[1
]}

Grenier, Philippe A. ^{[1
]}

Goldin, Jonathan ^{[1
]}

Han, MeiLan K. ^{[1
]}

Hanania, Nicola A. ^{[1
]}

Hansel, Nadia N. ^{[1
]}

Jacobson, Francine L. ^{[1
]}

Kauczor, Hans-Ulrich ^{[1
]}

Kinnula, Vuokko L. ^{[1
]}

Lipson, David A. ^{[1
]}

Lynch, David A. ^{[1
]}

MacNee, William ^{[1
]}

Make, Barry J. ^{[1
]}

Mamary, A. James ^{[1
]}

Mann, Howard ^{[1
]}

Marchetti, Nathaniel ^{[1
]}

Mascalchi, Mario ^{[1
]}

McLennan, Geoffrey ^{[1
]}

Murphy, James R. ^{[1
]}

Naidich, David ^{[1
]}

Nath, Hrudaya ^{[1
]}

Newell, John D., Jr. ^{[1
]}

Pistolesi, Massimo ^{[1
]}

Regan, Elizabeth A. ^{[1
]}

Reilly, John J. ^{[1
]}

Sandhaus, Robert ^{[1
]}

Schroeder, Joyce D. ^{[1
]}

Sciurba, Frank ^{[1
]}

Shaker, Saher ^{[1
]}

Sharafkhaneh, Amir ^{[1
]}

Silverman, Edwin K. ^{[1
]}

Steiner, Robert M. ^{[1
]}

机构：

[1] Natl Jewish Hlth, Div Radiol, Denver, CO 80206 USA

来源：

COPD-JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE | 2012年 / 9卷 / 02期

基金：

美国国家卫生研究院;

关键词：

CT; Visual evaluation; Airways; Emphysema; THIN-SECTION CT; COMPUTED-TOMOGRAPHY; ASYMPTOMATIC SUBJECTS; DISEASE; EMPHYSEMA; LUNG; AGREEMENT; SEVERITY; SMOKING; ECLIPSE;

D O I：

10.3109/15412555.2012.654923

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

The purposes of this study were: to describe chest CT findings in normal nonsmoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring. Methods: Volumetric inspiratory and expiratory CT scans of 294 subjects, including normal non-smokers, smokers without COPD, and smokers with GOLD Stage I-IV COPD, were scored at a multi-reader workshop using a standardized worksheet. There were 58 observers (33 pulmonologists, 25 radiologists); each scan was scored by 9-11 observers. Interobserver agreement was calculated using kappa statistic. Median score of visual observations was compared with QCT measurements. Results: Interobserver agreement was moderate for the presence or absence of emphysema and for the presence of panlobular emphysema; fair for the presence of centrilobular, paraseptal, and bullous emphysema subtypes and for the presence of bronchial wall thickening; and poor for gas trapping, centrilobular nodularity, mosaic attenuation, and bronchial dilation. Agreement was similar for radiologists and pulmonologists. The prevalence on CT readings of most abnormalities (e. g. emphysema, bronchial wall thickening, mosaic attenuation, expiratory gas trapping) increased significantly with greater COPD severity, while the prevalence of centrilobular nodularity decreased. Concordances between visual scoring and quantitative scoring of emphysema, gas trapping and airway wall thickening were 75%, 87% and 65%, respectively. Conclusions: Despite substantial interobserver variation, visual assessment of chest CT scans in cigarette smokers provides information regarding lung disease severity; visual scoring may be complementary to quantitative evaluation.

引用

页码：151 / 159

页数：9

共 24 条

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