Kappa统计量评价中耳胆脂瘤的高分辨率CT诊断  

Application of the Kappa Statistic in the High Resolution Computerized Tomograph on Diagnosis of Middle Ear Cholesteatoma

作　　者：李永奇[1] 韩正理 

机构地区：[1]中山大学附属第三医院耳鼻咽喉科,510630 [2]广东省深圳市宝安区福永医院

出　　处：《中国实用医药》2010年第27期11-13,共3页China Practical Medicine

摘　　要：目的应用Kappa统计量评价不同观察者对中耳胆脂瘤的高分辨率CT(HRCT)诊断的一致性。方法回顾分析150例慢性中耳炎患者共166侧耳的颞骨HRCT图像,所得结果与原始颞骨HRCT报告结果进行Kappa统计分析;进一步以手术中及病理结果为金标准,分别评价颞骨HRCT初诊和再诊对中耳胆脂瘤和听骨链病变的敏感性、特异性和准确性。结果中耳胆脂瘤HRCT初诊和再诊具有很好的诊断一致性,其Kappa值为0.752;HRCT对胆脂瘤破坏听骨链的诊断一致性良好,Kappa值为0.60;颞骨HRCT初诊和再诊对中耳胆脂瘤和听骨链病变的敏感性、特异性和准确性分别是86.9%、93%、91.6%和84.8%、91.7%、89.8%;颞骨HRCT初诊和再诊对听骨链病变的敏感性、特异性和准确性分别为86.6%、90.4%、88.6%和85.4%、81%、83.1%。结论 HRCT初诊和再诊对中耳胆脂瘤的诊断一致性良好,但在显示听骨链的完整形态方面一致性稍差。Objective To evaluate the diagnostic consistency of different observers in HRCT diagnosis of middle ear cholesteatoma with the Kappa statistic. Methods The HRCT imaging of one hundred and fifty cases （ 166 ears） of chronic otitis media were retrospectively analyzed by an experienced temporal bone radiologist. He was asked to diagnose middle ear cholesteatoma and ossicle chain. The results were compared with the original reporters and the histopathological reports using the Kappa Statistic. Results For middle ear chol-esteatoma,the original and the second-look reports had excellent diagnostic consistency and the Kappa value was 0. 752. For ossicle chain,two results had good agreement and the Kappa value was 0. 60. Conclusion HRCT has a very good diagnostic value on cholesteatoma of the middle ear but a lower value on the ossicle chain.

关 键 词：KAPPA统计量 胆脂瘤 中耳 计算机体层X线摄影术 高分辨率 

分 类 号：R764[医药卫生—耳鼻咽喉科]