CAJ | 학술논문

目的：探讨CT结肠成像诊断结肠息肉中放射科医师评估诊断的差异。方法收集2013年4月-2015年3月期间我院检查的120例高度怀疑为结肠息肉患者的CT结肠影像，由4位不同水平的放射科医师(不知道纤维结肠镜结果)分别在使用和不使用辅助诊断工具(计算机辅助检测， Computer-Aided Detection，CAD)的情况下进行阅片，以纤维结肠镜检查为金标准，观察不同水平医师在不同情况下对结肠息肉检出的敏感性、特异性、准确性、阳性预测值和阴性预测值。结果同水平医师在相同诊断条件下对结肠息肉检出情况比较差异无明显的统计学意义(P＞0.05)；不同水平的医师在无辅助诊断工具的情况下对结肠息肉检出情况比较差异有明显的统计学意义(P＜0.05)；不同水平的医师在使用辅助诊断工具的情况下对结肠息肉检出情况比较差异无明显的统计学意义(P＞0.05)；高年资水平的医师在使用辅助诊断工具后，对结肠息肉的检出率相对提高，但与不使用辅助诊断工具时检出情况相比差异无明显的统计学意义(P＞0.05)。结论 CT结肠成像诊断结肠息肉评估受放射科医师的年资水平的影响很大，通过采用CAD辅助诊断评估可以缩小或消除由不同年资水平造成的诊断差异。
목적：탐토CT결장성상진단결장식육중방사과의사평고진단적차이。방법수집2013년4월-2015년3월기간아원검사적120례고도부의위결장식육환자적CT결장영상，유4위불동수평적방사과의사(불지도섬유결장경결과)분별재사용화불사용보조진단공구(계산궤보조검측， Computer-Aided Detection，CAD)적정황하진행열편，이섬유결장경검사위금표준，관찰불동수평의사재불동정황하대결장식육검출적민감성、특이성、준학성、양성예측치화음성예측치。결과동수평의사재상동진단조건하대결장식육검출정황비교차이무명현적통계학의의(P＞0.05)；불동수평적의사재무보조진단공구적정황하대결장식육검출정황비교차이유명현적통계학의의(P＜0.05)；불동수평적의사재사용보조진단공구적정황하대결장식육검출정황비교차이무명현적통계학의의(P＞0.05)；고년자수평적의사재사용보조진단공구후，대결장식육적검출솔상대제고，단여불사용보조진단공구시검출정황상비차이무명현적통계학의의(P＞0.05)。결론 CT결장성상진단결장식육평고수방사과의사적년자수평적영향흔대，통과채용CAD보조진단평고가이축소혹소제유불동년자수평조성적진단차이。
Objective To explore the use of colon CT imaging in the diagnosis of colon polyps radiologists to assess differences.Methods Collection in April 2013 to March 2015 period in our hospital between examination was highly suspected as colon polyps in 120 cases of patients with colon CT image data, by four different levels of radiologists in use and do not use the auxiliary diagnostic tool for reading, fiber colonoscopy as gold standard, at different levels of doctors in different cases of colon polyps detection sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results At the physician in the diagnosis of colon polyps detection under the condition of same comparison difference has no obvious statistical significance (P>0.05); Different levels of physicians in without auxiliary diagnostic tool for colon polyps detected situation is difference have significant statistical significance (P<0.05); Different levels of physicians in the use of auxiliary diagnostic tools of colon polyps detection under the condition of comparison difference has no obvious statistical significance (P>0.05); High qualification levels of physicians in the use of auxiliary diagnostic tools, relative improve detection rate of colon polyps, but with the auxiliary diagnostic tool is not used there was no obvious difference detection than statistical significance (P>0.05).Conclusion CT imaging in the diagnosis of colon colon polyps assessment greatly depends on the level of seniority of radiologists, by adopting CAD auxiliary diagnosis can reduce or eliminate differences.