Slice profile characteristics of MPR images in multi-slice CT

Few studies have investigated the detailed imaging characteristics of multiplanar reconstruction (MPR) images, which have come to be used in imaging diagnosis. The purpose of this study was to evaluate the slice profile characteristics of MPR images. The slice profile of a coronal image was measured by the bead method. Moreover, it assumed that the slice profile of an MPR image became a convolution of the square profile corresponding to the nominal slice thickness and line spread function (LSF) of an axial image, and the simulation was performed. The nominal slice thicknesses of the original axial image and coronal image were 1.0 mm, 2.0 mm, and 3.0 mm. Three reconstruction kernels (B20, B30, and B40) of the original axial image were used. The results of measurement revealed that the full width at half maximum (FWHM) values were 1.7 mm for reconstruction kernel B20 and 1.3 mm for reconstruction kernel B40 in the case of a nominal slice thickness of 1.0 mm. The simulated and measured modulation transfer factors (MTF) were in close agreement. Then the slice profile of the coronal (sagittal) MPR image forms by the convolution of a LSF of the y- (x-) direction and the square profile with a nominal MPR slice width, and is affected by the reconstruction kernel.     

Temporal bone anatomy: correlation of multiplanar reconstruction sections and three-dimensional computed tomography images

Two axial and coronal section planes are commonly used for a conventional computed tomography diagnosis of the temporal bone. In recent years, sagittal and oblique section planes have been reformatted using high-resolution multiplanar reconstruction (MPR). Detailed three-dimensional (3D) images are also employed. To understand the 3D structure of the small, complicated temporal bone, we compared common angle MPR section planes with 3D images. We also suggest four-section planes, which are optimal for observing the ossicular chain.     

多层螺旋CT面神经管全程多平面重组显示及其在骨折中的诊断价值

目的 经重组得到2幅显示面神经管(FNC)全程的斜位多平面重组(MPR)图像,并验证其在骨折中的诊断效能.资料与方法 收集100耳正常颞骨CT图像(正常组),经MPR得到同层显示FNC鼓室段、锥曲及乳突段的斜位图像A与同层显示迷路段、膝状窝及鼓室段的斜位图像B,计算斜位图像A、B的MPR重组成功率.选择43耳经手术证实的FNC骨折CT图像(对照组),计算斜位图像A、B重组成功率,对比分析诊断模式Ⅰ(常规轴位+冠状位)与诊断模式Ⅱ(常规轴位+冠状位+斜位图像A或B)对骨折显示率的差异.结果 正常组斜位图像A、B重组成功率分别为96.00％、97.00％.对照组斜位图像A、B重组成功率分别为97.67％、95.35％,模式Ⅰ对骨折显示率为48.84％,模式Ⅱ对骨折显示率为81.40％,两者对骨折显示率差异有统计学意义(P＜0.05).结论 通过本文的MPR固定重组步骤,可用2幅斜位图像显示FNC全程,常规轴位和冠状位图像与斜位图像A或B联合应用可提高FNC骨折的诊断准确性.     

多层螺旋CT对椎体后缘软骨结节的诊断

目的:探讨椎体后缘软骨结节在多层螺旋CT(MSCT)的表现及特点,提高对该病变的显示及诊断率。方法:25例椎体后缘软骨结节进行螺旋CT扫描、薄层重建后再进行轴位、矢状及冠状面重建,分析比较几种重建方法对椎体后缘软骨结节的显示效果。结果:轴位重建清晰显示腰椎体后缘骨质缺损、游离骨块及合并相应水平椎间盘突出情况;矢状位重建是对轴位重建的良好补充,并可以较好显示相应水平硬膜囊受压情况;冠状位重建对显示椎体后缘骨缺损及游离骨块也有一定帮助。结论:多层螺旋CT及多平面重建(MPR)在椎体后缘软骨结节的影像学诊断中具有重要意义。     

大脑中动脉CTA-MIP后处理参数的优化及初步研究

目的应用CT血管成像(CTA)最大密度投影(MIP)的多平面重组(MPR)后处理技术分析大脑中动脉(MCA)分段显示与所选层面厚度及角度间的关系,确定MCA分段显示的优化参数。方法回顾性分析2014年6月—2016年6月因疑似MCA缺血行头颅CTA及数字减影血管造影(DSA)检查的100例病人(764处节段血管)资料,其中男60例,女40例,平均(64.3±10.7)岁。利用CTA容积再现(VR)平台,分别测量所有病例M1段、M2段、M2-5段的空间跨度及走行角度参数值并进行分组,随后在CTA-MIP-MPR平台,对MPR厚度和偏移角度的不同测试值进行验证,并对各个重组影像进行质量评分,确定各分段最优参数,并将优化CTA-MIP影像与DSA影像进行比较分析,评价其优化效果。多组间比较采用单因素方差分析,应用受试者操作特征(ROC)曲线评价优化CTA-MIP诊断血管狭窄的价值, CTA与DSA检查结果的一致性分析采用Kappa检验。结果在CTA-MIP中,MCA M1段最优化参数为冠状面、层厚15 mm、角度偏移0°,其影像质量评分为3.85±0.51,均高于其他组(均P0.05);MCA M2段最优化参数为矢状面、层厚25 mm、角度偏移0°,其影像质量评分为3.36±0.53,均高于其他组(均P0.05);M2-5段最优化参数为(1)低头冠状面、层厚35 mm、角度偏移35°;(2)外旋矢状面、层厚35 mm、轴转25°、矢转30°;2组影像质量评分分别为3.41±0.40、3.42±0.33,均高于其他组(均P0.05)。优化CTA-MIP检查对血管狭窄的诊断敏感度、特异度、阳性预测值、阴性预测值、ROC曲线下面积分别为90.5%、97.7%、87.5%、98.3%、0.941。对于4种不同狭窄程度血管的诊断,优化CTA-MIP检查与DSA检查结果一致率为96.5%(κ=0.783,P0.05)。结论基于优化的选层厚度及偏移角度,CTA-MIP分段显示能够清晰展示MCA各段管腔大小、走行及分支细节,与DSA有较高的一致性。     

螺旋CT多平面重组在副鼻窦检查中的应用

目的 :利用螺旋CT多平面重组技术探讨副鼻窦轴位扫描能否代替直接冠状位扫描。方法 :对 15例能合作的患者 ,均行副鼻窦轴位及冠状位扫描。使用美国GEProspeedFII双排螺旋CT机 ,层厚 5mm ,螺距 0 .75 ,连续横轴位扫描 ,利用多平面重组 (MPR)技术得到冠状位、矢状位重组图像 ;直接冠状位扫描获取冠状位图像 ;将同一患者的两组不同冠状位图像比较 ,主要观察各鼻窦窦壁及窦口。结果 :轴位扫描后重组所获图像亦能从多方位多角度观察 ,清楚显示各鼻窦及窦口。结论 :重组冠状位图像与直接冠状位扫描图像效果相同 ,可以取代直接冠状位扫描。避免后者检查时头部后仰造成的不适 ,患者容易接受 ,值得推广。     

Comparison between coronal reformatted images and direct coronal CT images of the swine lung specimen: assessment of image quality with 64-detector row CT

The aims of this study were to compare the image quality of coronal multiplanar reconstruction (MPR) images from axial spiral images with that of direct coronal spiral and sequential images, and to estimate and analyse the effect of an incremental change on the image quality using 64-detector row CT. 12 swine lungs were used. Five kinds of images from each lung specimen were obtained using 64-detector row CT. All images were analysed by categories and grades, and the direct coronal sequential images were used as the reference standard for the image quality. Statistical analysis was performed for the following categories: (i) inter-observer reliability, (ii) interaction between the observers and images, (iii) image analysis, (iv) anatomical structural analysis of each observer, (v) stair-step artefact and (vi) background noise. The overall image quality and the image quality of all anatomical structures of coronal MPR images with 0.67 mm slice increments were inferior to the image quality of the other images; this difference was statistically significant (p<0.05). Stair-step artefact was detected on coronal MPR images, and was more prominent on coronal MPR images with 0.67 mm slice increments than on coronal MPR images with 0.34 mm slice increments. The most severe background noise was detected on the direct coronal sequential images, but there was no significant difference between the direct coronal sequential images and the direct coronal spiral images. Background noise was least prominent on coronal MPR images with 0.67 mm slice increments. The increment process is important for improving the image quality of MPR images even when using 64-detector row CT. Coronal MPR images with 0.34 mm slice increments using 64-detector row CT showed a similar image quality to that obtained from the direct coronal images, and can be used instead. This means that the coronal MPR images obtained with 64-detector row CT could be as useful for evaluating the lung parenchyma as the axial high-resolution CT images.     

MSCT斜轴位多平面重组图像在面神经管膝状窝及其周围骨折诊断中的价值

目的探讨MSCT扫描斜轴位MPR在面神经管膝状窝及其周围骨折中的诊断价值。方法收集经行颅中窝面神经减压手术证实的面神经管膝状窝或鼓室段近端骨折患者33例,回顾分析其术前CT图像,将术中所见与常规轴位、冠状位及斜轴位MPR图像所见对比。比较2种诊断模式(常规轴位及冠状位联合应用,常规轴位、冠状位及斜轴位MPR联合应用)对面神经管膝状窝及其周围骨折的诊断符合率。结果术前CT显示骨折线累及膝状窝或鼓室段近端22例(66.67%),其中常规轴位显示8例(24.24%),冠状位显示6例(18.18%),斜轴位显示20例(60.61%)。常规轴位或冠状位及斜轴位图像均能显示骨折线累及膝状窝或鼓室段近端10例,仅斜轴位显示12例,常规轴位、冠状位或斜轴位均不能显示11例。斜轴位MPR显示面神经管膝状窝或鼓室段近端局限性扩大26例(78.79%)。统计分析表明2种不同的诊断模式对膝状窝及其周围骨折诊断符合率有统计学差别。结论斜轴位MPR与常规轴位、冠状位图像联合观察可提高术前面神经管膝状窝及其周围骨折的诊断符合率。     

多层螺旋CT不同角度MPR图像诊断腰椎弓峡部裂的对照研究

目的研究64层CT不同角度MPR图像诊断腰椎弓峡部裂的价值。方法利用64层CT扫描的50例腰椎弓峡部裂病例的各向同性扫描的容积数据,采用不同角度的多平面重组(MPR)方式进行图像后处理。利用MPR模拟出4种扫描模式(1)常规的椎间盘扫描方式的断面图像;(2)腰椎横断面图像;(3)沿椎弓方向的斜横断位(椎弓反角度扫描)图像;(4)沿腰椎长轴的矢状断面图像。分析4种方法的峡部裂隙检出率、峡部裂断端错位检出率、碎骨片检出率、假关节形成检出率。结果峡部裂隙检出率以矢状MPR图像、斜横断MPR(100%)最高(u=8.51,P<0.05);峡部裂断端错位检出率以矢状MPR图像(90%)最高(u=4.18,P<0.05);碎骨片检出率以斜横断MPR(28%)和矢状MPR图像(20%)最高(u=2.08,P<0.05);假关节形成检出率以斜横断MPR(18%)最高(u=2.237,P<0.05)。结论64层CT后处理图像的多平面重组(MPR)可以从不同角度、不同平面分析椎弓峡部裂的各种征象。     

Routine isotropic computed tomography scanning of chest: value of coronal and sagittal reformations

OBJECTIVE: We sought to evaluate the usefulness of coronal and sagittal reformations from isotropic chest computed tomography (CT) examinations. METHODS: A total of 30 chest CT examinations were reconstructed into 2 sets of axial source images: 0.9-mm slice width with 0.45-mm reconstruction interval (isotropic) and 4-mm slices with 3-mm reconstruction interval. The isotropic dataset was reformatted into coronal and sagittal stacks with 4-mm slices. Three readers reviewed the image sets with 4-mm slice widths. Coronal and sagittal reformations were compared at the same sitting to axial images for depiction of anatomy and disease in the aorta, pulmonary arteries, hilar regions, mediastinum, lung parenchyma, pleura, diaphragm, thoracic spine, ribs, and trachea. A 5-point scale was used to determine whether nonaxial reformations showed anatomy and disease significantly better, somewhat better, same, somewhat worse or significantly worse than equivalent thickness axial source images. A 3-point scale was used to score if nonaxial image sets showed no, some, or significant additional information compared with the axial plane regarding the main diagnosis. RESULTS: There was better visualization of the hilar regions, diaphragm, spine, and trachea on the coronal reformations compared with source axial images (P < 0.05). Sagittal reformations scored better than axial source images for aorta, pleura, diaphragm, spine, and ribs (P < 0.05). The coronal and sagittal series showed significant additional information in 11% and 9% of patients, respectively. CONCLUSION: Radiologists should consider the use of one or both of coronal and sagittal planes in addition to the axial series in routine interpretation of chest CT.     

多向调整多平面重组在听小骨显示中的作用评价

目的探讨多向调整多平面重组（MPR）技术全程显示听小骨及其关节的方位和方法。方法对50侧正常中耳行高分辨率CT各向同性扫描后再行多向调整MPR后处理，确定听小骨同层全程显示的基础显示方位、重组基线旋转中心点和旋转方向的定向解剖标志，测量重组基线旋转角度，对听小骨在轴面、冠状面、矢状面及多向调整MPR全程显示位4种方位上的全程显示程度进行分级，做Ridit分析和x^2检验。结果多向调整MPR锤骨、砧骨、镫骨的同层全程显示率均为100％（50侧中耳），多向调整MPR对于听小骨全程显示率明显高于轴面（镫骨6侧、锤骨0侧、砧骨0侧）、冠状面（锤骨3侧、镫骨0侧、砧骨0侧）、矢状面（锤骨0侧、砧骨0侧、镫骨0侧），差异有统计学意义（P〈0．01）。结论（1）各向同性扫描基础上的多向调整MPR技术提供了具有诊断意义的听小骨全程显示方法，具有重要临床应用价值。（2）只需1次扫描多次MPR后处理，就可取代多次多方位扫描，是听小骨多方位整体观察的必要途径之一。     

CT多平面重组在镫骨病变诊断中的价值

目的：探讨Cr多平面重组(multi-plier reformation，MPR)在显示镫骨病变中的价值。方法：对106例(148耳)镫骨异常者行平行枕眶线扫描，应用轴位图像行多方位螺旋CT多平面重组。行听骨链重建术60例(66耳)，术中观察镫骨的形态、结构和破坏情况，并与MPRCT图像对照。结果：慢性中耳炎合并镫骨破坏71例(100耳)；先天性镫骨异常35例(48耳)，其中砧、镫骨分离6例(8耳)，镫骨头及足弓完全缺如10例(14耳)，镫骨足弓不完整、一侧足弓缺如4例(5耳)，镫骨板增厚与周围骨融合15例(21耳)。与术中所见比较，镫骨斜位MPR图像显示镫骨形态、结构异常的符合率为95．45％。结论：冠状位和镫骨斜位MPR显示镫骨足弓的形态和结构以及了解镫骨的破坏情况有重要价值，可准确做出镫骨病变的CT诊断。     

颞骨平行枕眶线多层螺旋CT扫描法及其价值

目的:探讨以平行枕眶线扫描图像为基础的常规轴位和冠状位MPR图像是否能够取代直接轴位和冠状位图像。方法:三位医师分别观察50例颞骨CT扫描图像,分析直接常规轴位(25例)、冠状位(25例)CT扫描图像和其相应的常规轴位、冠状位MPR图像显示颞骨结构的差异。结果:所有观察者均认为直接常规轴位、冠状位CT扫描图像略优于相应的轴位、冠状位MPR图像。直接轴位、冠状位CT扫描图像和相应的轴位、冠状位MPR图像的质量差异较小。结论:以平行枕眶线扫描图像为基础的常规轴位和冠状位MPR图像可取代直接轴位和冠状位扫描图像。     

MR imaging of the anterior cruciate ligament: value of thin slice direct oblique coronal technique

PURPOSE: The value of the thin slice direct oblique coronal technique, which is parallel to the anterior cruciate ligament (ACL), was assessed in the evaluation of ACL injury in comparison with conventional oblique sagittal and coronal images. MATERIAL AND METHODS: A thin slice direct oblique coronal technique was developed and applied clinically to 62 patients after conventional oblique sagittal and coronal images had been obtained. MR images of these 62 patients (24 with tears and 38 without tears) with an arthroscopic correlation were evaluated by three radiologists who were unaware of the arthroscopic results. The diagnostic accuracy of these new images was compared with that of oblique sagittal and coronal images by ROC analysis. RESULTS: Conventional oblique sagittal and coronal images for the diagnosis of ACL tears revealed accuracies of 82%, 84%, and 84%, sensitivities of 92%, 92%, and 96% and specificities of 76%, 79%, and 76% for the three reviewers, respectively. On thin slice direct oblique coronal images, specificities of 97%, 97%, and 97%, sensitivities of 96%, 96%, and 96%, and accuracies of 97%, 97%, and 97% were obtained, respectively. Diagnostic ability was significantly better with direct oblique coronal images (mean area under the ROC curve [Az]=0.99) than with conventional oblique sagittal and coronal images (Az=0.91) (p<0.05). CONCLUSION: The addition of thin slice direct oblique coronal images significantly improved specificity and accuracy in the diagnosis of ACL tears.     

磁共振膝关节斜冠状位扫描对前交叉韧带的评价

目的　探讨磁共振膝关节斜冠状位扫描对前交叉韧带的显示价值。方法　对 3 0例正常膝关节均行常规横断、斜矢状、冠状扫描 ,扫描序列还包括在斜矢状图像基础上行平行于前交叉韧带FSE序列斜冠状薄层无间隔T2 扫描 ,分析斜冠状、斜矢状及冠状位对正常前交叉韧带的显示情况。结果　正常膝关节于 1幅图片上可清楚显示ACL全程者 ,斜冠状显示率为 10 0 % (3 0 3 0 ) ,斜矢状位显示率为 83 .3 % (2 5 3 0 ) ,而冠状位前交叉韧带呈节段状 ,不能在 1幅图像中显示完整的ACL。结论　斜冠状位可在 1幅图像上完整显示前交叉韧带起止附着区及中间纤维束 ,有利于对前交叉韧带显示及损伤后的评价     

膝关节侧副韧带MRI显示方法分析

目的 探讨正常人膝关节侧副韧带MRI检查方法及表现. 方法 对55例成人选择矢状面、冠状面、后斜冠状面进行MR扫描,观察侧副韧带显示的情况,测量内、外侧副韧带的有关数据,并与解剖文献大体测量结果进行比较. 结果 (1)矢状面上内侧副韧带的定位线与胫骨干长轴的夹角为0.55°±0.25°;外侧副韧带的定位线与腓骨颈长轴的夹角为11.47°±1.61°.(2)内侧副韧带在常规冠状位1个层面上完整显示占96%,同时外侧副韧带在1个层面上完整显示占82%;外侧副韧带在11°后斜冠状位1个层面上完整显示占90%.(3)正常内、外侧副韧带在T1WI和PDWI上均呈扁平条状低信号,平均长度分别为11.53 cm和5.31 cm.结论选择完全显示胫骨干、腓骨颈的矢状面为基准面,层厚3 mm MR扫描能很好地显示内、外侧副韧带的解剖结构.     

螺旋CT多功能重建方式对腰椎峡部裂的诊断价值

目的探讨螺旋CT(SCT)不同重建方式对腰椎峡部裂(spondyloschisis,SS)的诊断价值。方法对32例腰椎峡部裂行容积扫描后,进行表面重建(SSD)、多方位多平面重建(MPR)、改良法最大密度投影(MIP)等后处理,并由2位有经验的高年资放射科医生将获得的图像进行比较、分析。结果SSD显示SS20例22处及14例椎体滑脱,图像立体感强,解剖关系清晰;SSD结合切割(cut)及任意剖面技术,观察SS裂隙及局部骨痂、骨赘等细节,弥补了SSD只能显示感兴趣区表面改变的不足,进一步提高了对较小SS裂隙的显示率。MPR包括矢状位重建、冠状位重建、平行于椎板的左右斜位重建、沿椎管曲面重建(CPR)、平行椎弓轴线的反角度轴位重建(reversangleaxialreconstruction,RAAR)等,能显示全部32例73处SS及全部14例椎体滑脱;利用MPR的任意窗口技术可以分别显示局部骨质和软组织改变,并可对病变进行准确测量。MIP及其多角度投影技术、改良法切割技术,可以多方位、立体直观显示全部SS及其形态、走向、局部骨质改变等。结论螺旋CT多功能重建方式相互匹配是诊断SS的最佳方案,具有重要的临床应用价值。     

Normal shoulder: MR imaging

Relatively poor spatial resolution has been obtained in magnetic resonance (MR) imaging of the shoulder because the shoulder can only be placed in the periphery of the magnetic field. The authors have devised an anatomically shaped surface coil that enables MR to demonstrate normal shoulder anatomy in different planes with high spatial resolution. In the axial plane, anatomy analogous to that seen on computed tomographic (CT) scans can be demonstrated. Variations in scapular position (produced by patient positioning) may make reproducibility of sagittal and coronal plane images difficult by changing the relationship of the plane to the shoulder anatomy. Oblique planes, for which the angle is chosen from the axial image, have the advantage of easy reproducibility. Obliquely oriented structures and relationships are best seen in oblique plane images and can be evaluated in detail.     

面神经隐窝入路关键手术剖面多层螺旋CT双斜面多平面重组的研究

目的 探讨双斜面CT MPR重组技术对面神经隐窝进路手术中关键手术剖面涉及到的解剖标志同层显示的可行性及方法.方法 在尸体头颅标本上观察面神经隐窝入路手术中涉及到的关键手术剖面及相关解剖标志,利用双斜面MPR重组技术,对30具(60侧)完整的成年国人尸体头颅标本进行关键手术剖面重组,对比手术剖面主要解剖标志观察结果,对4个不同方位图像(横断面、冠状面、矢状面及双斜矢状面)同层显示主要解剖标志的程度进行分级评价.主要手术解剖标志同层显示为100％者记为4级、显示为90％～99％记为3级、显示为80％～89％记为2级、显示70％～79％记为l级,显示＜70％记为0级.对所得资料行x2检验.结果 面神经隐窝入路手术中涉及到4层关键手术剖面,均为斜矢状面.4层关键手术剖面双斜面MPR重组的旋转中心标志点分为水平半规管、砧骨窝、锥隆起及圆窗后缘;重组水平参考轴线及水平旋转角度分别为砧骨短突及22.15° ±5.22°、砧骨短突及20.15°±5.52°、面神经水平段及32.53°±5.22°、卵圆窗上缘及50.15°±8.02°;重组垂直参考轴线均为面神经垂直段,垂直旋转角度分别为14.35°±4.02°、13.15°±3.33°、15.05° ±4.43°及15.25°±4.12°.对于主要解剖标志同层显示的程度,在第1层关键手术剖面中,双斜矢状面为4级60侧,横断面为2级12侧、3级48侧,冠状面为2级15侧、3级45侧,矢状面为3级10侧、4级50侧;第2层关键手术剖面中,双斜矢状面为4级60侧,横断面为2级11侧、3级49侧,冠状面为2级13侧、3级47侧,矢状面为3级11侧、4级49侧;第3层关键手术剖面中,双斜矢状面为4级60侧,横断面为2级10侧、3级50侧,冠状面为2级11侧、3级49侧,矢状面为3级9侧、4级51侧;第4层关键手术剖面中,双斜矢状面为4级60侧,横断面为2级9侧、3级51侧,冠状面为2级8侧、3级52侧,矢状面为3级5侧、4级55侧;4层关键手术剖面解剖标志同层显示在不同方位图像显示程度差异均有统计学意义(x2值分别为123.3200、121.4231、122.4011、125.4213,P值均＜0.05);4层关键手术剖面解剖标志双斜面同层显示成功率均为100％(60/60侧).结论 双斜面MPR重组技术可清晰同层显示面神经隐窝径路手术剖面相关解剖标志,能为术者提供更有使用价值的影像学信息.     

Multislice helical CT: the value of multiplanar image reconstruction in assessment of the bronchi and small airways disease

We examined 23 consecutive patients (11 males and 12 females with mean age of 56 years) with possible airway diseases to assess the impact of multiplanar image reconstruction (MPR) on the degree of confidence and accuracy in diagnosing bronchial abnormalities and emphysema. The thorax was scanned contiguously at 1 mm slice thickness using Siemens Volume Zoom Multislice CT scanner. Images were reconstructed at 1 mm slice thickness (lung windows L-600HU W-1600HU utilizing high spatial frequency algorithm) in the axial (10 mm apart), sagittal (4 images per lung) and coronal (6 images) plane. Paddle wheel image reconstructions were also performed in the assessment of bronchiectasis. Axial images were assessed with and without the help of MPR by three chest radiologists at two separate occasions (at least 4 weeks apart). The presence of bronchiectasis, emphysema and bronchiolitis in each lobe was documented on a confidence scale of 0 to 3. The overall mean confidence for each observer with and without MPR was compared. Consensus diagnosis was used as the gold standard for the assessment of the diagnostic accuracy of each observer. A confidence score of 2 or more for any lobe was considered diagnostic of the particular airway disease. The diagnostic accuracy for each observer with and without MPR was compared. Consensus reporting diagnosed bronchiectasis in 7 patients (30.4%), bronchiolitis in 5 patients (21.7%) and emphysema in 12 patients (52%). MPR did not increase the confidence of assessing the different abnormalities for all observers but improvement in diagnosing bronchiectasis was noted in two observers. The improvement did not reach statistical significance. However, agreement between observers in the diagnosis of bronchiectasis and emphysema was improved when the MPR images were used in conjunction with standard axial imaging (Kappa statistic improved from 0.29 to 0.54 for bronchiectasis and from 0.7 to 0.81 for emphysema). Agreement on the diagnosis of bronchiolitis was not improved by MPR for all observers. Our results suggest that MPR seems to improve the confidence in diagnosing bronchiectasis and emphysema.