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Assessment of bronchiectasis: comparison of HRCT and spiral volumetric CT
B A van der Bruggen-Bogaarts1, H M van der Bruggen, P F van Waes
1Department of Pulmonology, University Hospital Utrecht, The Netherlands.
Objective:
Our goal was to ascertain the sensitivity of spiral CT for the detection of bronchiectasis in comparison with high resolution CT (HRCT).
Materials And Methods:
Thirty-one patients with a suspected clinical diagnosis of bronchiectasis were evaluated with spiral CT (slice thickness 5 mm, pitch 1, reconstruction index 2 mm, 1 s rotation) and HRCT (1.5 mm, interval 10 mm). Analysis of the presence, type, and severity of bronchiectasis was performed for each bronchopulmonary lobe.
Results:
In 30 patients, 177 lobes were evaluated. At HRCT 14 patients showed signs of bronchiectasis in 32 lobes. Spiral CT confirmed the presence in 29 lobes. In one lobe spiral CT was false positive. The severity score was the same in 23 lobes, in 4 lobes higher at HRCT, and in 2 lobes higher at spiral CT. Spiral CT has a high sensitivity of 91% to detect bronchiectasis with a specificity of 99.3%. Spiral CT demonstrates adequately lack of tapering of the bronchus.
Conclusion:
In patients with suspected bronchiectasis, HRCT is the method of first choice based on greater sensitivity and lower radiation dose. However, spiral CT done for other indications is a reliable method for assessment of bronchiectasis. Inability of patients to hold their breath did not prove to interfere with diagnostic reliability.