Eosinophilic lung diseases:: Diagnostic accuracy of thin-section CT in 111 patients
Eosinophilic lung diseases:: Diagnostic accuracy of thin-section CT in 111 patients
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DOI：
10.1148/radiology.216.3.r00se01773
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发表时间：
2000-09-01
期刊：
影响因子：
19.7
通讯作者：
Nakamura, H
中科院分区：
文献类型：
--
作者：
Johkoh, T;Müller, NL;Nakamura, H
目的：确定是否可以通过薄层计算机断层扫描 (CT) 来区分各种嗜酸性粒细胞性肺部疾病。 材料和方法：对 111 例嗜酸性粒细胞性肺部疾病患者进行薄层 CT 扫描，其中 40 例患有慢性嗜酸粒细胞性肺炎，16 例患有 Churg-Strauss 综合征，16 例患有过敏性支气管肺曲霉病 (ABPA)，13 例患有慢性嗜酸性粒细胞性肺炎。急性嗜酸性粒细胞肺炎、12 例单纯性肺嗜酸性粒细胞增多症、11 例药物引起的嗜酸性粒细胞性肺炎和 3 例嗜酸性粒细胞增多综合征，由两名观察者独立评估。观察者记录异常情况、诊断以及诊断的置信度。结果：两名观察者平均在 61% 的读数中做出了正确的首选诊断。慢性嗜酸粒细胞性肺炎的诊断正确率为78%； 81%，急性嗜酸性肺炎； 44%，Churg-Strauss综合征； 84%，ABPA； 17%，单纯性肺嗜酸性粒细胞增多； 27%，药物性嗜酸性粒细胞性肺炎； 33% 为嗜酸性粒细胞增多综合征。两位观察者对 36% 的读数做出了正确的诊断，置信度很高。观察者对于正确诊断（kappa，0.47）和高度置信度的正确诊断（kappa，0.59）之间存在中等程度的一致性。结论：虽然嗜酸性粒细胞性肺部疾病通常可以通过薄层 CT 来区分，但明确的诊断需要 CT 表现与仔细的临床评估之间的相关性。
PURPOSE: To determine whether various eosinophilic lung diseases can be differentiated by means of thin-section computed tomography (CT).MATERIALS AND METHODS: Thin-section CT scans in 111 patients with eosinophilic lung diseases-40 with chronic eosinophilic pneumonia, 16 with Churg-Strauss syndrome, 16 with allergic bronchopulmonary aspergillosis (ABPA), 13 with acute eosinophilic pneumonia, 12 with simple pulmonary eosinophilia, 11 with drug-induced eosinophilic pneumonia, and three with hypereosinophilic syndrome-were assessed independently by two observers. The observers recorded the abnormalities, diagnosis, and degree of confidence in the diagnosis.RESULTS: The two observers made a correct first-choice diagnosis on average in 61% of readings. The correct diagnosis was made in 78% of cases of chronic eosinophilic pneumonia; 81%, acute eosinophilic pneumonia; 44%, Churg-Strauss syndrome; 84%, ABPA; 17%, simple pulmonary eosinophilia; 27%, drug-induced eosinophilic pneumonia; and 33%, hypereosinophilic syndrome. The two observers made a correct diagnosis with a high degree of confidence in 36% of readings. There was moderate agreement between the observers for the correct diagnosis (kappa, 0.47) and for the correct diagnosis with a high degree of confidence (kappa, 0.59).CONCLUSION: Although eosinophilic lung diseases often can be differentiated by means of thin-section CT, correlation between CT findings and careful clinical evaluation are required for a definitive diagnosis.