数字合成体层成像和X线数字摄影在肺内结节探测中敏感度的比较  

Comparison of digital tomosynthesis and conventional digital radiography on detection sensitivity for pulmonary nodules

作　　者：张梦龙[1] 孙峰[1] 王雅莹[1] 张华[2] 

机构地区：[1]山东省医学影像学研究所,山东济南250021 [2]山东省菏泽市立医院介入科,山东菏泽274031

出　　处：《医学影像学杂志》2013年第4期597-600,共4页Journal of Medical Imaging

摘　　要：目的比较数字合成体层成像(DTS)和普通X线数字摄影对肺内结节探测的敏感度,评价DTS检测肺内小结节的能力。方法 22名有肺内小结节的患者进行随访性CT检查,由2名放射医师共同对CT扫描图像进行阅读,来证实结节的存在并为其定位,作为结节存在的标准。另外为患者进行了后前位胸部X线数字摄影(PA)和DTS检查。再由另外3位胸部放射医师独立阅读DTS影像和PA影像,来确定CT所证实的结节在这两种影像上的显示情况。结节按以下标准进行分级:肯定可见,不确定,不可见。3个级别按直径大小分为以下三组:<5,5～10,>10mm。分析那些标记为肯定可见的结节的真阳性结果。结果 CT断层扫描共检出180个直径范围在3.5～19.5mm的结节,DTS和PA的敏感度分别是67%和23%(P<0.0001)。一致性检验表明,在所有三组不同大小的结节中,DTS和PA对肺内结节的检出率均有统计学差异,其中对小结节(直径<5mm)的探测敏感度,两者分别达到49%和10%。结论和PA相比,在各类大小不同的肺内小结节的探测中,DTS都显示出较大的敏感性。Objective To compare digital tomosynthesis （DTS） and conventional digital radiography on detection sensi- tivity for pulmonary nodules and to evaluate DTS for improving detectability of small lung nodules. Methods Twenty-two patients underwent computed tomography （CT） to follow up lung nodules. Two chest radiologists reviewed all CT data to confirm presence, location and size of all nodules 〉3 mm in diameter for each subject. The same 22 subjects received an additional digital post/anterior conventional chest radiography （PA） and DTS exam. Three chest radiologists in a consen- sus panel then independently reviewed DTS images and PA images to confirm visualization of nodules identifed by CT. All nodules were classified as definitely visible, uncertain, or not visible. In each class, nudules were then grouped according size.. 〈5, 5~ 10, and 〉10 mm. Only nodules that were clssified definitely visible were counted as true positives, compar- isons of sensitivities of nodule detection were statistically compared between PA and DTS relative to the reference standard CT. Results 180 nodules （diameter range 3.5~19.5 mm） were found in the 22 patients. Sensitivities for all nodules by DTS and PA were 67% and 23%, respectively （ P 〈0. 0001）. A highly statistically diffrence in detection sensitivity was noted hetween DTS and PA at all nodule sizes. Considering only the small nodules （〈3 mm in diameter）, almost half were visible in the DTS images, compared with only 10% in the PA radiographs. Conclusion DTS showed significantly improved sensitivity of detection of known small lung nodules in all sizes, when compared to PA chest radiography.

关 键 词：数字合成体层成像 肺结节 胸部摄影 

分 类 号：R561[医药卫生—呼吸系统] R814.3[医药卫生—内科学]