数字化X线胸片计算机辅助检测对肺结节检出率的影响  

Effect of computer:aided detection in digital radiograph on the diagnosis of pulmonary nodules:a simulation study

作　　者：费军[1] 黄海滨[2] 张朝利[1] 郑冬[1] 陈宁[1] 赵亮[1] 刘军华[1] 

机构地区：[1]解放军306医院,北京100101 [2]西门子中国研究院,北京100102

出　　处：《中国医学影像技术》2009年第3期509-511,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨计算机辅助检测(CAD)系统对X线胸片肺结节检出率的影响。方法选取经CT检查的肺内结节患者70例和100名正常者的数字化胸片,由2名专家组医生参照CT片,阅读相应胸片并标记结节部位,意见达成一致后得出结论,将该结论与CAD系统产生的假阳性结节组合模拟成三类敏感度已知(50%、75%和100%)的CAD检测结果。另外6名放射科医生(2名高年资,4名低年资)分别在不用和应用CAD辅助的情况下阅读胸片,并得出结论。结果应用CAD系统后,所有医生的检测敏感性均得到显著提高;低年资医生检测敏感性提高的幅度大于高年资医生;不同敏感度的CAD系统对医生检测敏感性的提高程度有显著差异,但多重比较结果表明100%与75%敏感度的CAD系统对医生检测敏感性提高的影响无显著区别。结论CAD可显著提高影像诊断医生的检测敏感性。CAD系统存在一个敏感度临界点,提高CAD系统的敏感度并不一定能够显著提高医生的检测敏感性。Objective To investigate the effect of computer-aided detection in digital radiograph on the detection of pulmo nary nodules. Methods Digital chest radiographs （70 cases with pulmonary nodules confirmed by CT and 100 normal sub jects） were enrolled. The consensus of 2 experienced radiologists after reading the chest radiograph and CT were considered as reference standard. The simulated CAD results with known sensitivity （50%, 75% and 100%） were generated by mixing of the true nodules and false positives. Other 6 radiologists （2 experienced and 4 residents） interpreted the chest radiographs without and then with the use of CAD. Results The use of CAD improved the diagnostic sensitivity of all radiologists signif icantly. The extent of improvement for residents was larger than that of experienced radiologists. The CAD system with dif ferent sensitivities had different impact on improvement of radiologists＇ diagnosis sensitivity. However, the results of multiple comparisons showed that the CAD system with sensitivity of 100% and 75% was not significantly different on improvement of the radiologists＇ diagnosis sensitivity. Conclusion The use of CAD can improve the radiologists＇ detective sensitivity significantly. There is a critical point for sensitivity of CAD system. The improvement of sensitivity of CAD system does not necessarily improve the radiologists＇ diagnostic sensitivity.

关 键 词：肺结节 计算机辅助检测 模拟研究 

分 类 号：TP319[自动化与计算机技术—计算机软件与理论] R445[自动化与计算机技术—计算机科学与技术]