中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2013年
8期
709-712
,共4页
杨亮%宋伟%隋昕%金征宇%王沄
楊亮%宋偉%隋昕%金徵宇%王沄
양량%송위%수흔%금정우%왕운
多发肺结节%诊断技术,呼吸系统
多髮肺結節%診斷技術,呼吸繫統
다발폐결절%진단기술,호흡계통
Multiple pulmonary nodules%Diagnosis techniques,respiratory system
目的 评价双源CT在低剂量扫描前提下肺结节加强观察(NEV)功能的诊断效能.方法 在肺转移瘤或筛查肺癌随诊的患者中,采用数字表法随机抽取127例进行胸部CT低剂量扫描.CT图像由2名具有10年以上胸部影像诊断经验的医师,共同阅片诊断的肺结节为诊断标准.由住院医师分别采用和不采用辅助NEV分析软件阅读同一组CT图像,记录单独NEV软件、住院医师采用辅助NEV分析软件和不采用辅助情况下发现的肺结节数量和阅读时间.对结果采用秩和检验进行比较.同时以具有10年以上胸部影像诊断经验的医师的结果为标准,分别计算3种情况下诊断的敏感度和准确度.结果 高年资医师、住院医师、NEV及NEV辅助医师发现最大径≤2.0 cm的非钙化肺结节数量分别为570、404、768、593个,2/3以上的肺结节最大径＜0.5 cm.住院医师发现的最大径≤2.0 cm与＜0.5 cm肺结节数量均明显少于NEV发现的,两者间差异有统计学意义(Z值分别为-6.887和-7.235,P均＜0.01).住院医师使用NEV后发现的最大径≤2.0 cm与＜0.5 cm肺结节数量比使用前均明显增多,两者间差异有统计学意义(Z值分别为-6.606和-6.657,P均＜0.01).住院医师、NEV、住院医师应用NEV发现最大径≤2.0 cm肺结节的敏感度与准确度分别为61.4％、86.3％、95.3％与56.1％、58.1％、87.6％,发现最大径＜0.5 cm肺结节的敏感度与准确度分别为51.4％、88.1％、94.8％与47.0％、56.9％、87.5％.住院医师、NEV、住院医师借助NEV的阅读时间分别为120 ～444 s/例、85 ～ 262 s/例、131～1512 s/例.住院医师使用与不使用NEV的阅读时间差异有统计学意义(Z=-9.781,P＜0.01).住院医师平均花费(23±10)s判断NEV发现的每个肺结节可疑区域.结论 NEV有助于住院医师发现肺结节,尤其是对＜0.5 cm的肺结节.但是在判断肺结节的性质方面,NEV不能代替医师.
目的 評價雙源CT在低劑量掃描前提下肺結節加彊觀察(NEV)功能的診斷效能.方法 在肺轉移瘤或篩查肺癌隨診的患者中,採用數字錶法隨機抽取127例進行胸部CT低劑量掃描.CT圖像由2名具有10年以上胸部影像診斷經驗的醫師,共同閱片診斷的肺結節為診斷標準.由住院醫師分彆採用和不採用輔助NEV分析軟件閱讀同一組CT圖像,記錄單獨NEV軟件、住院醫師採用輔助NEV分析軟件和不採用輔助情況下髮現的肺結節數量和閱讀時間.對結果採用秩和檢驗進行比較.同時以具有10年以上胸部影像診斷經驗的醫師的結果為標準,分彆計算3種情況下診斷的敏感度和準確度.結果 高年資醫師、住院醫師、NEV及NEV輔助醫師髮現最大徑≤2.0 cm的非鈣化肺結節數量分彆為570、404、768、593箇,2/3以上的肺結節最大徑＜0.5 cm.住院醫師髮現的最大徑≤2.0 cm與＜0.5 cm肺結節數量均明顯少于NEV髮現的,兩者間差異有統計學意義(Z值分彆為-6.887和-7.235,P均＜0.01).住院醫師使用NEV後髮現的最大徑≤2.0 cm與＜0.5 cm肺結節數量比使用前均明顯增多,兩者間差異有統計學意義(Z值分彆為-6.606和-6.657,P均＜0.01).住院醫師、NEV、住院醫師應用NEV髮現最大徑≤2.0 cm肺結節的敏感度與準確度分彆為61.4％、86.3％、95.3％與56.1％、58.1％、87.6％,髮現最大徑＜0.5 cm肺結節的敏感度與準確度分彆為51.4％、88.1％、94.8％與47.0％、56.9％、87.5％.住院醫師、NEV、住院醫師藉助NEV的閱讀時間分彆為120 ～444 s/例、85 ～ 262 s/例、131～1512 s/例.住院醫師使用與不使用NEV的閱讀時間差異有統計學意義(Z=-9.781,P＜0.01).住院醫師平均花費(23±10)s判斷NEV髮現的每箇肺結節可疑區域.結論 NEV有助于住院醫師髮現肺結節,尤其是對＜0.5 cm的肺結節.但是在判斷肺結節的性質方麵,NEV不能代替醫師.
목적 평개쌍원CT재저제량소묘전제하폐결절가강관찰(NEV)공능적진단효능.방법 재폐전이류혹사사폐암수진적환자중,채용수자표법수궤추취127례진행흉부CT저제량소묘.CT도상유2명구유10년이상흉부영상진단경험적의사,공동열편진단적폐결절위진단표준.유주원의사분별채용화불채용보조NEV분석연건열독동일조CT도상,기록단독NEV연건、주원의사채용보조NEV분석연건화불채용보조정황하발현적폐결절수량화열독시간.대결과채용질화검험진행비교.동시이구유10년이상흉부영상진단경험적의사적결과위표준,분별계산3충정황하진단적민감도화준학도.결과 고년자의사、주원의사、NEV급NEV보조의사발현최대경≤2.0 cm적비개화폐결절수량분별위570、404、768、593개,2/3이상적폐결절최대경＜0.5 cm.주원의사발현적최대경≤2.0 cm여＜0.5 cm폐결절수량균명현소우NEV발현적,량자간차이유통계학의의(Z치분별위-6.887화-7.235,P균＜0.01).주원의사사용NEV후발현적최대경≤2.0 cm여＜0.5 cm폐결절수량비사용전균명현증다,량자간차이유통계학의의(Z치분별위-6.606화-6.657,P균＜0.01).주원의사、NEV、주원의사응용NEV발현최대경≤2.0 cm폐결절적민감도여준학도분별위61.4％、86.3％、95.3％여56.1％、58.1％、87.6％,발현최대경＜0.5 cm폐결절적민감도여준학도분별위51.4％、88.1％、94.8％여47.0％、56.9％、87.5％.주원의사、NEV、주원의사차조NEV적열독시간분별위120 ～444 s/례、85 ～ 262 s/례、131～1512 s/례.주원의사사용여불사용NEV적열독시간차이유통계학의의(Z=-9.781,P＜0.01).주원의사평균화비(23±10)s판단NEV발현적매개폐결절가의구역.결론 NEV유조우주원의사발현폐결절,우기시대＜0.5 cm적폐결절.단시재판단폐결절적성질방면,NEV불능대체의사.
Objective To evaluate efficacy in detecting lung nodules at low-dose CT(LDCT) by nodule enhanced viewing(NEV).Methods One hundred and twenty seven patients who were referred to undergo low-dose CT (LDCT) for the evaluation of pulmonary metastasis or screening lung cancer were selected randomly.Two radiologists with at least 10 years experience read the images with normal clinical reading speed to find actionable nodules ≤ 2.0 cm in maximum diameter,and their consensus result was referred as "Standard".NEV was adopted to detect the pulmonary nodules.Two residents with experience of less than three years read first detected suspicious nodules and recorded reading time,first consensus and mean time were recorded.Then,they made second decisions on the images with the help of NEV and the results and the reading time were recorded and analyzed by using wilcoxon test.The sensitivity and accuracy of NEV,residents and residents with NEV were analyzed.Results "Standard",resident,NEV and resident with NEV detected 570,404,768 and 593 lung nodules ≤2.0 cm in maximum diameter,respectively.More than 60％ nodules were less than 0.5 cm in maximum diameter.The performance of NEV in detecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of the resident(Z =-6.887,P ＜0.01 and Z =-7.235,P ＜0.01),and the performance of resident with NEV indetecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of resident without NEV (Z =-6.606,P ＜ 0.01 and Z =-6.657,P ＜ 0.01).The resident,NEV and the resident with NEV detected nodules ＜ 20 mm in maximum diameter with sensitivities of 61.4％,86.3％ and 95.3％,and with accuracy of 56.1％,58.1％ and 87.6％,respectively.The resident achieved sensitivities of 51.4％,88.1％ and 94.8％,and accuracy of 47.0％,56.9％ and 87.5％ for nodules ＜5 mm in maximum diameter,respectively.The resident,NEV and resident with NEV spent 120-444 s,85-262 s and 131-1512 s per case to read the CT scans,respectively.The reading time of resident with NEV in was significantly higher than that of resident without NEV(Z =-9.781,P ＜ 0.01).The resident spent 23 s per NEV mark.Conclusion NEV considerable improves the resident's performance in lung nodule detection,especially in maximum diameter ＜ 0.5 cm nodule detection.
