title: High-resolution computed tomography scores in cystic fibrosis patients colonized with Pseudomonas aeruginosa or Staphylococcus aureus.
abstract: OBJECTIVE
  To compare HRCT findings in cystic fibrosis (CF) patients chronically colonized with Pseudomonas aeruginosa or Staphylococcus aureus using the modified Bhalla CT scoring system, as well as to evaluate intraobserver and interobserver reliability of the method.
  
  
  METHODS
  This was a retrospective cross-sectional study involving 41 CF patients, 26 of whom were chronically colonized with P. aeruginosa (Pa group), and 15 of whom were colonized with S. aureus (Sa group).Two independent radiologists evaluated the HRCT scans of these patients using the modified Bhalla CT scoring system in two different moments. Intraobserver and interobserver reliability was calculated using the intraclass correlation coefficient (ICC).
  
  
  RESULTS
  There was good intraobserver and interobserver agreement (ICC > 0.8). Scores were higher in the Pa group than in the Sa group for observer 1 (mean, 13.50 ± 3.90; median, 13.5 vs. mean, 5.00 ± 5.28; median, 3.0) and for observer 2 (mean, 11.96 ± 5.07; median, 12.0 vs. mean, 5.07 ± 5.65; median, 5.0). In addition, HRCT findings, such as bronchiectasis, bronchial wall thickening, mucus plugging, generation of bronchial divisions, and mosaic attenuation/perfusion pattern, were more prevalent in the Pa group.
  
  
  CONCLUSIONS
  The modified Bhalla CT scoring system was reproducible and reliable for use in the evaluation of HRCT scans, allowing distinctions to be drawn between the two groups of patients under study. The higher scores in the Pa group provided evidence of greater pulmonary impairment in that group.
authors.affiliation: Serviço de Pneumologia Pediátrica, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. taniafolescu@hotmail.com
authors.forename: Tania Wrobel
authors.initials: TW
authors.lastname: Folescu
authors.forename: Elizabeth de Andrade
authors.initials: Ede A
authors.lastname: Marques
authors.forename: Márcia Cristina Bastos
authors.initials: MC
authors.lastname: Boechat
authors.forename: Pedro
authors.initials: P
authors.lastname: Daltro
authors.forename: Laurinda Yoko Shinzato
authors.initials: LY
authors.lastname: Higa
authors.forename: Renata Wrobel Folescu
authors.initials: RW
authors.lastname: Cohen
mesh_terms: D001987:Bronchiectasis / Q000000981:diagnostic imaging*; D002648:Child; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000382:microbiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D009093:Mucus / Q000000981:diagnostic imaging; D015588:Observer Variation; D011552:Pseudomonas Infections / Q000000981:diagnostic imaging*; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*