计算机辅助诊断软件在CT多期扫描识别和评价小肝癌中的应用  

Computer Assistance Diagnosis in the Application of Identifying and Evaluating Small Hepatocellular Carcinoma by Multiphase MDCT

作　　者：宋伟[1] 金征宇[1] 徐颖[1] 魏国强 王沄[1] 钱建中[2] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院放射科,北京100730 [2]美国医软信息科技有限公司

出　　处：《实用放射学杂志》2007年第10期1319-1321,共3页Journal of Practical Radiology

基　　金：国家科技攻关计划基金项目(编号:2001BA705B10-17)

摘　　要：目的评价计算机辅助诊断在MDCT肝脏多期增强扫描识别小肝细胞癌(hepatocellular carcinoma,HCC)及对所识别的HCC强化特点定量的可行性。方法2名有经验的放射科诊断医师共同阅读已经确诊的49例HCC患者的CT图像,用常规方法标记可疑病变区域并测量病变大小,达成一致的诊断结果作为金标准。这2名医师使用计算机辅助工具IQQA-Liver再次共同阅读所选的图像。分析IQQA-Liver识别病灶结果与金标准的相关性,用IQQA-Liver自动定量病灶强化特点。结果金标准标记了86个HCC。IQQA-Liver识别了327个可疑病灶,其中63个与金标准标记的一致,占金标准的73.3%(63/86),伴有平均每例患者5.4个假阳性。金标准标记的86个HCC中,65.1%显示为等/低-高-低-低强化类型,24.3%显示为等/低-低-低-低强化类型,其他为不典型强化类型;从平扫期至动脉期、从动脉期至门静脉期和从门静脉期至延迟期的病灶强化变量分别为(24.2±10.3)HU、(-24.3±11.1)HU和(-15±5.1)HU。结论IQQA-Liver有助于识别、诊断小HCC。Objective To evaluate the feasibility of computer assistance diagnosis in the identification of small hepatocellular carcinoma （ HCC ） using multiphase contrast - enhanced MDCT, and in quantifying enhancement characteristics of such identified HCC. Methods 49 patients were already diagnosed with HCC. Two experienced physicians readed all the CT images including marking suspicious HCC locations and measuring their sizes in routine reading environment. Consensus reading was used as gold - standard reference. Computer tool IQQA - Liver was used to identify and evaluate suspicious lesions. The correlation between computer - identified lesions and consensus reading was computed and analyzed, and then the enhanced characteristics of such lesions were quantified using IQQA - Liver. Results 86 suspicious HCCs were identified by gold standard. The IQQA - Liver showed 327 suspicious HCCs in total,among which, 63 suspicious HCCs coincided with gold standard（73.3% ）. All false positives added up to 5.4 per study on average. For the 86 suspicious HCCs identified by gold standard, 65.1% had an iso/hypo - hyper - hypo - hypo enhanced pattern, 24.3% showed an iso/hypo - hypo - hypo - hypo enhanced pattern, the rest had atypical enhanced patterns. The lesion - to - liver contrast changes for 86 suspicious HCCs （ irrespective of their enhancement patterns）from precontrast to arterial phases, from arterial to portal venous phases, and from portal venous to delayed phases were （24.2 ± 10.3 ） HU, （ - 24.3± 11.1 ） HU, and （ - 15 ± 5.1 ） HU, respectively. Conclusion Computer tools are useful in assisting the identification and diagnosis of liver lesions.

关 键 词：肝脏 肝癌 计算机辅助诊断 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]