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Screening for bronchiectasis. A comparative study between chest radiography and high-resolution CT
B A van der Bruggen-Bogaarts1, H M van der Bruggen, P F van Waes
1Department of Pulmonology, University Hospital Utrecht, the Netherlands.
Study Objective:
The aim of our study was to investigate whether in the search for bronchiectasis a correlation exists between abnormalities on the chest radiograph and high-resolution CT (HRCT), and if HRCT has an additional value when the chest radiography is normal.
Subjects And Methods:
In a prospective study, chest radiographs were compared with HRCT in 84 patients. Analysis of presence and extent of bronchiectasis were made for each bronchopulmonary lobe.
Results:
Thirty-seven patients had a normal radiograph, from whom 32 had a normal HRCT. The other 5 had a low HRCT severity score with a mild cylindrical bronchiectasis. From the 47 patients with an abnormal radiograph, 36 had signs of bronchiectasis at HRCT; 11 patients, however, had a normal HRCT. The sensitivity for chest radiography to detect bronchiectasis appeared to be 87.8% with a specificity of 74.4%. We found a significant linear relationship between the severity of bronchiectasis at HRCT and abnormalities as seen on the chest radiograph (r=0.62, p=0.0001).
Conclusion:
A normal chest radiograph almost always excludes relevant bronchiectasis and no further investigation seems necessary. There is a significant linear relationship between the severity of bronchiectasis at HRCT and abnormalities as seen on the chest radiograph.