不同分辨率单色显示器对数字化X线成像肺结节检出效能的评价  

Evaluation of the different resolution of grayscale display over the detection efficiency of pulmonary nodule

作　　者：尹建东[1] 郭启勇[1] 张伟[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004

出　　处：《中华放射学杂志》2009年第3期290-293,共4页Chinese Journal of Radiology

摘　　要：目的评价医用单色液晶显示器的不同分辨率对肺结节检出效能的影响。方法从PACS系统中在线选取胸部数字化X线成像（DR）影像图93幅，其中正常图（CT和DR均无结节）23幅、疑诊图（仅DR上有结节征象）32幅、确诊图（CT图显示结节）38幅。影像图上结节直径0．30～1．90cm，均无明显钙化影；确诊病例中多发结节9例。请住院（低年资）医师或研究生、主治（中年资）医师、副主任或主任（高年资）医师各3名，分别在3种显示器[Barco Z-2261（2M）、Barco Z-3620（3M）、Barco Z-5620（5M）]上集中3次读片。对于结节的评价采用5等分法：肯定有、可能有、不确定、可能没有、肯定没有，每名医师针对每个显示器上的每张图像给出自己的信任等级。采用SPSS11．5对结果进行ROC曲线的绘制及Z检验。结果高年资医师使用2、3、5M的显示器检测肺结节的ROC曲线下面积（AUC）分别为0．774、0．784、0．816，中年资医师分别为0．754、0．764、0．768，低年资医师分别为0．695、0．754、0．774。在相同分辨率显示器上不同年资的医师之间及同年资医师在不同分辨率的显示器上对肺结节的检出效能差异均无统计学意义（P〉0．05）。结论在检测肺结节时，使用分辨率为2、3、5M医用单色液晶显示器的效能相当；高年资的医师使用5M的显示器会得到更多的信息；通过显示器的合理配置可以提高性价比。Objective To evaluate the influence of the resolution of medical grayseale LCD over the detective efficiency of pulmonary nodule. Methods By reviewing PACS, 93 on-line chest DR images were collected. These radiographs included 23 normal images that had no nodule confirmed by CT, 32 doubtful images that also had no nodule confirmed by CT,and 38 positive images that had nodules confirmed by CT. These nodules didn＇ t show obvious calcification and their diameters were from 0. 30 to 1.90 cm. Nine patients had multi-nodules. Three residents or postgraduates,three attending physicians, and three associate professors or professors interpreted the 93 chest images by using three types of displays： Barco Z-2261 ,Barco Z-3620 and Bareo Z-5620. All observers evaluated their confidence of the presence of pulmonary nodule with five-point level rating scale ： （ 1 ） definitely positive, （ 2 ） probably positive, （ 3 ） uncertain, （4） probably negative, （5） definitely negative. SPSS 11.5 software was used to analyze the re, suits ,including to draw the ROC curves and to perform Z test. Results The areas under the ROC curves of 2 M display, 3 M display and 5 M display were 0. 774,0. 784,0. 816 for experienced radiologists ; for instructors were 0. 754,0. 764, 0. 768 ;for teaching assistants were 0. 695,0. 754,0. 774. However, for the detection of pulmonary nodules, there was no significant difference between observers with different ranks using the same modality of display, and no significant difference was found between the different modalities of displays used by observers with the same rank. Conclusion It＇s equivalent for detection performance with 2,3 and 5 M medical grayscale LCD display in detecting pulmonary nodule; Experienced radiologists can get more information using 5 M display; By reasonably matching displays, we could improve the cost-efficacy.

关 键 词：结节病 肺 ROC曲线 对比研究 

分 类 号：R686[医药卫生—骨科学]