Radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography

Abstract

ObjectiveTo evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT).Materials and MethodsThe HRCT scans of 43 patients with bronchiectasis were analyzed by two radiologists, who used a scoring system to grade the findings. Kappa (κ) values and overall agreement were calculated.ResultsFor the measurement and appearance of bronchiectasis, the interobserver agreement was moderate (κ = 0.45 and κ = 0.43, respectively), as was the intraobserver agreement (κ = 0.54 and κ = 0.47, respectively). Agreement on the presence of mucous plugging was fair, for central distribution (overall interobserver agreement of 68.3% and κ = 0.39 for intraobserver agreement) and for peripheral distribution (κ = 0.34 and κ = 0.35 for interobserver and intraobserver agreement, respectively). The agreement was also fair for peribronchial thickening (κ = 0.21 and κ = 0.30 for interobserver and intraobserver agreement, respectively). There was fair interobserver and intraobserver agreement on the detection of opacities (κ = 0.39 and 71.9%, respectively), ground-glass attenuation (64.3% and κ = 0.24, respectively), and cysts/bullae (κ = 0.47 and κ = 0.44, respectively). Qualitative analysis of the HRCT findings of bronchiectasis and the resulting individual patient scores showed that there was an excellent correlation between the observers (intraclass correlation coefficient of 0.85 and 0.81 for interobserver and intraobserver agreement, respectively).ConclusionIn the interpretation of HRCT findings of bronchiectasis, radiologist agreement appears to be fair. In our final analysis of the findings using the proposed score, we observed excellent interobserver and intraobserver agreement.

The radiological diagnosis of bronchiectasis: what's in a name?

“…These definitions probably work quite well in daily clinical practice for highly abnormally widened airways and/or in those who show a lack of tapering over multiple generations. For such advanced bronchiectasis airways, there will be fair to good inter-or intraobserver reproducibility of the diagnosis [9]. However, for the detection of early or mild stages of bronchiectasis disease, the radiological diagnosis becomes more critical and there will be more variability between observers.…”

Ratio of the Bronchial Lumen to Pulmonary Artery Diameter in Rhesus Macaques (Macaca mulatta) without Clinical Pulmonary Disease

“…14 Many studies describe the CT appearance of bronchiectasis in humans. 7,19,20 Dilation of the bronchus, bronchial wall thickening, lack of tapering, indistinct bronchus within 1 cm of pleura, and mucus plugging (tree-in-bud sign) have all been reported as major CT signs of bronchiectasis in human patients. 7,17 Until currently, the 'gold standard' for diagnosis of bronchiectasis has been highresolution CT imaging and the bronchoarterial ratio.…”

“…7,19,20 Dilation of the bronchus, bronchial wall thickening, lack of tapering, indistinct bronchus within 1 cm of pleura, and mucus plugging (tree-in-bud sign) have all been reported as major CT signs of bronchiectasis in human patients. 7,17 Until currently, the 'gold standard' for diagnosis of bronchiectasis has been highresolution CT imaging and the bronchoarterial ratio. 7 Given the close physical association between the bronchus and adjacent artery in the lung field and the fact that the internal diameter of the artery does not alter significantly along the bronchial airway, it is reasonable to use this artery as a reference for bronchial diameter.…”

“…7,17 Until currently, the 'gold standard' for diagnosis of bronchiectasis has been highresolution CT imaging and the bronchoarterial ratio. 7 Given the close physical association between the bronchus and adjacent artery in the lung field and the fact that the internal diameter of the artery does not alter significantly along the bronchial airway, it is reasonable to use this artery as a reference for bronchial diameter. 1 According to results from the current study, the bronchoarterial ratio in clinical healthy rhesus monkeys ranges from 0.54 to 0.64, with a mean of 0.59 ± 0.05 and 95% CI upper limit of 0.61.…”

Mounier-Kuhn syndrome: an unusual cause of bronchiectasis

“…The importance of tracheobronchial diseases has been emphasized in recent studies ( 1 - 4 ) . Tracheobronchomegaly, or Mounier-Kuhn syndrome, is a rare disease, observed mainly in middle-aged men before the fifth decade of life ( 5 ) , that is characterized by atrophy or the absence of elastic fibers or smooth muscle in the wall of the trachea and the main bronchi, resulting in dilatation of those structures ( 6 - 8 ) .…”