Correlation between clinical features, high-resolution computed tomography findings, and a visual scoring system in patients with pneumonia due to Mycoplasma pneumoniae

2018 ◽  
Vol 56 (4) ◽  
pp. 320-325 ◽  
Author(s):  
Takeshi Saraya ◽  
Kosuke Ohkuma ◽  
Yayoi Tsukahara ◽  
Takayasu Watanabe ◽  
Daisuke Kurai ◽  
...  
2013 ◽  
Vol 20 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Baykal Tulek ◽  
Ali Sami Kivrak ◽  
Seda Ozbek ◽  
Fikret Kanat ◽  
Mecit Suerdem

BACKGROUND: Identifying different phenotypes of chronic obstructive pulmonary disease (COPD) is important for both therapeutic options and clinical outcome of the disease.OBJECTIVE: To characterize the phenotypes of COPD according to high-resolution computed tomography (HRCT) findings; and to correlate HRCT scores obtained using the modified Bhalla scoring system with clinical and physiological indicators of systemic inflammation.METHODS: The present study included 80 consecutive patients with stable COPD. HRCT scans were evaluated by two independent radiologists according to the modified Bhalla scoring system.RESULTS: Fifty-four patients exhibited morphological changes on HRCT examination while 26 had no pathological findings. Patients with HRCT findings had lower spirometric measurements and higher levels of inflammation, and reported more exacerbations in the previous year compared with patients with no findings on HRCT. Patients with morphological changes were classified into one of three groups according to their HRCT phenotype(s): emphysema (E) only, E + bronchiectasis (B)/peribronchial thickening (PBT) or B/PBT only. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, C-reactive protein (CRP) levels and the number of exacerbations among the groups were significantly different. Pairwise comparisons between the E only and E+B/PBT groups showed significantly lower FVC, FEV1and FEV1/FVC values, and higher CRP levels and number of exacerbations compared with the B/PBT group. No significant differences were found between the E+B/PBT and the B/PBT groups. An inverse correlation was found between the total HRCT score and FVC, FEV1and FEV1/FVC; the correlation was positive with CRP level, erythrocyte sedimentation rate and number of exacerbations.CONCLUSION: The present study exposed the intimate relationship between phenotype(s) characterized by HRCT and scoring for morphological abnormalities; and clinical and functional parameters and inflammatory markers. The inclusion of HRCT among routine examinations for COPD may provide significant benefits both in the management and prognosis of COPD patients.


2017 ◽  
Vol 50 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Milene Carneiro Barbosa de Brito ◽  
Maurício Kenji Ota ◽  
Fernando Sergio Studart Leitão Filho ◽  
Gustavo de Souza Portes Meirelles

Abstract Objective: To evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT). Materials and Methods: The 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. Results: For 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). Conclusion: In 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.


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