CAJ | 학술논문

目的应用ROC曲线分析法探讨256层螺旋CT诊断肋软骨骨折的最佳窗宽、窗位.方法对30例患者行胸部256层螺旋CT扫描.由3位影像医师分别测量所有病例肋软骨CT值,并采用"双盲法"在PACS网上软拷贝阅读每例患者甲(1120 HU窗宽,-100 HU窗位)、乙(1120 HU窗宽,100 HU窗位)、丙(1120 HU窗宽,300 HU窗位)3种窗宽、窗位的图像,并在①肯定正常,②可疑正常,③不能肯定,④可疑骨折,⑤肯定骨折中做出选择.采用SPSS 16.0统计软件进行数据处理,对诊断结果进行ROC曲线分析,以ROC曲线下的面积(Az)大小表示3位医师3种窗宽、窗位下的诊断准确率.结果 256层螺旋CT诊断结合临床随访确诊8例共12处肋软骨骨折.30例患者肋软骨的平均CT值为(98.78±32.86)HU.3位医师1120 HU窗宽、100 HU窗位下Az值均大于其他两种窗宽、窗位(P=0.045,P=0.002,P均＜0.05),表明该窗宽、窗位的诊断效能更为优越.K检验表明所有诊断结果3位医师组间一致性较高.结论 256层螺旋CT能够有效诊断肋软骨损伤,优化最佳窗宽、窗位有助于影像诊断.
목적 응용ROC곡선분석법탐토256층라선CT진단륵연골골절적최가창관、창위.방법 대30례환자행흉부256층라선CT소묘.유3위영상의사분별측량소유병례륵연골CT치,병채용"쌍맹법"재PACS망상연고패열독매례환자갑(1120 HU창관,-100 HU창위)、을(1120 HU창관,100 HU창위)、병(1120 HU창관,300 HU창위)3충창관、창위적도상,병재①긍정정상,②가의정상,③불능긍정,④가의골절,⑤긍정골절중주출선택.채용SPSS 16.0통계연건진행수거처리,대진단결과진행ROC곡선분석,이ROC곡선하적면적(Az)대소표시3위의사3충창관、창위하적진단준학솔.결과 256층라선CT진단결합림상수방학진8례공12처륵연골골절.30례환자륵연골적평균CT치위(98.78±32.86)HU.3위의사1120 HU창관、100 HU창위하Az치균대우기타량충창관、창위(P=0.045,P=0.002,P균＜0.05),표명해창관、창위적진단효능경위우월.K검험표명소유진단결과3위의사조간일치성교고.결론 256층라선CT능구유효진단륵연골손상,우화최가창관、창위유조우영상진단.
Objective To investigate the optimal window level and center level settings in the diagnosis of costal cartilage fracture with 256-slice spiral CT through ROC analysis. Methods Thirty patients with suspected costal cartilage fractures underwent 256-slices chest spirals CT scaning. CT value of costal cartilage was measured by three experienced radiologists. The soft copy images of three kinds of window level and window width (-100 HU/1120 HU, 100 HU/1120 HU, 300 HU/1120 HU) were analyzed independently in PACS with dual-blind method, and the diagnosis results were taken ROC analysis with SPSS 16.0 software. The diagnostic accuracy of three physicians were evaluated and compared according to the area under the ROC curve (Az). Results A total of 8 patients of costal cartilage fractures were confirmed by CT diagnosis combined with clinical follow-up. The mean CT value of 30 patients was (98.78±32.86) HU. The area under the ROC curve with the window level and center level settings of (100 HU/1120 HU) were bigger than that of other window level and window width (P=0.045,P=0.002). Kappa identity test showed that there was a powerful conformability between the diagnostic results of three physicians. Conclusion 256-slice spiral CT is a good way for the diagnosis of costal cartilage fractures with suitable window level and center level settings.