数字化断层融合对肺内小结节检出价值的ROC曲线评价  

ROC curve＇s evaluation of digital tomosynthesis for detection of pulmonary nodules

作　　者：张殿星[1] 武乐斌[1] 田军[1] 巩武贤[1] 黄世廷[1] 李同芬[1] 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250021

出　　处：《实用放射学杂志》2011年第11期1659-1662,1666,共5页Journal of Practical Radiology

摘　　要：目的探讨数字化断层融合（DTS）在肺内小结节检出中的应用价值。方法43例经MSCT证实肺内小结节与43例经MSCT证实无肺内小结节患者均行后前位DR与DTS检查，由4位影像学诊断医师采用5级法分别对后前位DR与DTS网像上结节的有无进行评分并记录．以MSCT图像作为参照标准．对后前位DR与DTS的检出结果进行ROC曲线评价。结果后前位DR与DTS检出肺内小结节的ROC曲线下的面积（Az）分别为0．763±0．247（0．755、0．768、0．735、0．794）与0．941±0．209（0．946、0．910、0．951、0．956），2种检查方法的差异具有统计学意义（t=10．954，P=0．02，P〈0．05）。4位阅片医师对肺部小结节检出诊断一致性分析Kappa值均〉0．75，诊断一致性较好。结论DTs对肺内小结节的检出明显优于后前位DR，具有较高的应用价值，可作为疑有肺内小结节患者的常规检查方法。Objective To disscus the applied value of digital tomosynthesis（DTS） for detection of pulmonary nodules. Methods 43 patients with and 43 patients without pulmonary nodule underwent thoracic MSCT, posterior-anterior DR and DTS. MSCT served as reference method. The suspected pulmonary nodules were evaluated by 4 radiologists using a 5-point rating scale for the confidence of presence. The results were statistically analyzed with ROC curve. Results For the detection of pulmonary nodules, the area under ROC curves in DR（PA） group and in DTS group were 0. 763±0. 247（0. 755 , 0. 768 , 0. 735 , 0. 794 respectively ） and 0.941±0.209（0.946,0.910,0.951,0.956 respectively）. The difference between the Az valves in the two groups was significant （t=10. 954,P = 0.02,P〈0. 05）. The agreement confirmed by 4 radiologists in detection of pulmonary nodules was fine（ Kappa〉 0.75）. Conclusion The performance of DTS is better than that of DR（PA） in the detection of pulmonary nodules. DTS may play an important role for the detection of pulmonary nodules.

关 键 词：肺 数字化断层融合 放射摄影术 肺结节 受试者操作特性曲线 

分 类 号：R563[医药卫生—呼吸系统] R814.4[医药卫生—内科学]