计算机辅助检测系统在数字化X线胸片肺结节筛查的临床应用  

Clinical Application of Computer-Aided Detection System for Pulmonary Nodules on Digital Chest Radiography

作　　者：朱洪章[1] 冯玉[1] 杨有优[1] 范淼[1] 王霁朏[1] 朱莹[1] 林润[1] 杨建勇[1] 杨艳红[1] 

机构地区：[1]中山大学附属第一医院放射科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2017年第4期614-617,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金面上项目(8161792)

摘　　要：【目的】探讨计算机辅助检测(CAD)系统在数字化X线胸片肺结节筛查中对不同年资放射医师的结节检测敏感性及观察者间变异的影响。【方法】由两名高年资医生筛选经CT证实的100例正常及200例含结节的后前位数字化胸片,并共同制定结节组结节的大小、位置的金标准。由另外的四名高年资及四名低年资医生独立对两组的胸片分别不用及应用CAD辅助阅片并保存结果。使用配对t检验评估两组医生在应用CAD辅助阅片之前与之后的平均结节检测敏感性的差异;使用变异系数(CV)对两组医生应用CAD辅助阅片之前与之后的观察者间变异进行评估。【结果】两组医生应用CAD辅助阅片之前及之后平均结节检测敏感性分别为(41.1±2.0)%、(28.0±2.0)%及(45.0±1.8)%、(39.2±0.9)%,两组医师在应用CAD辅助阅片之前与之后的平均检测敏感性有统计学差异;应用CAD辅助阅片之前及之后所有医师的平均检测敏感性变异系数分别为20.9%及8.1%。【结论】应用CAD能帮助放射科医师提高结节检出率,并能缩小不同年资医师间结节检测能力的差异。[Objective ] To observe the effect of computer-aided detection （CAD） system in improving lung nodule detection sen- sitivity and inter-observer variation. [ Methods ] 300 PA digital radiographs including 100 normal cases and 200 cases with pulmonary nodules confirmed by CT were enrolled. Two senior chest radiologists referenced CT images and marked the sizes and locations of all nodules with consensus as the gold standards. Four senior radiologists and four junior radiologists interpreted the digital chest radio- graphs independently without and with CADand recordtheir results. Pair t test and coefficient of variation （CV） was used to compare the difference of lung nodule detection sensitivity and inter-observer variation between withoutand with CAD. [ Results ] The mean lung nodule detection sensitivity of senior and junior radiologists withoutand with CAD were （41.1 ± 2.0）%, （28.0 ± 2.0）% and （45.0 ± 1.8）%, （39.2 ± 0.9）%, respectively, statistical analysis showed there was statistically significant difference. Moreover, CV of all radiologists without and with CAD were 20.9% and 8.1%. [Conclusion] Both lung nodule detection sensitivity and inter-observer variation of senior and junior radiologists can he improved by CAD.

关 键 词：肺结节 X线摄影术 计算机辅助诊断 

分 类 号：R814[医药卫生—影像医学与核医学]