Bronchiectasis: Diagnostic Accuracy of Chest Computed Radiography

Abstract

PURPOSE: The aim of this study was to assess the diagnostic accuracy of chest comput-ed radiography for thedetection of bronchiectasis diagnosed by high-resolution CT. MATERIALS AND METHODS: Our study included 100consecutive patients with bronchiec-tasis and 20 normal subjects, all seen on high-resolution CT. Two independentobservers analyzed chest computed radiographs and recorded the presence and type of bronchiectasis, and the invo lved lobe. RESULTS: On high-resolution CT, bronchiectasis was seen in one lobe in 29 patients, two lobes in 29,three lobes in 16, four lobes in 14, five lobes in 10, and six lobes in t wo. The bronchiectasis was tubular in 55patients, mixed tubular and cystic in 29, and cystic in 16. For observer 1, the sensitivity, specificity, andaccuracy of chest com-puted radiography was 95%, 85%, and 93%, respective l y, while for observer 2, thecorresponding figures were 93%, 85%, and 92%. Sensitivity and specificity for observ-er 1 were 33% and 96% for theright upper lobe (46% and 95% for observer 2), 68% and 86% for the right middle lobe (76% and 86%), 70% and 78%for the right lower lobe (48% and 83%), 50% and 100% for the left upper lobe (50% and 97%), 63% and 90% for thelingular segment (49% and 93%), and 87% and 75% for the left lower lobe (75% and 90%), respective l y. Tubularbronchiectasis involving a single lobe was the most common source of false negative readings based on the findingsof chest com-puted radiography. CONCLUSION: Because chest computed radiography is not inferior to high-resolutionCT for the detection of bronchiectasis, the routine use of chest computed radiography in screening forbronchiectasis is feasible. Howeve r, due to its low sensitivity in detect-ing bronchiectasis in a specific lobe,preoperative high-resolution CT examination may be needed.