PACS系统三维测量方法与多田公式计算方法在脑出血测量的准确性比较  

Comparison of accuracy between Picture Archiving and Communication Systems three-dimensional measuring method and Tada formula in intracerebral hemorrhage volume measurement

作　　者：张巧莹 黄晓宇 梁小红 周俊林[1,2,3] ZHANG Qiaoying;HUANG Xiaoyu;LIANG Xiaohong;ZHOU Junlin(Department of Radiology,Lanzhou University Second Hospital,Lanzhou 730030,China;Second School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Key Laboratory of Medical Imaging in Gansu Province,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730030 [2]兰州大学第二临床医学院,甘肃兰州730000 [3]甘肃省医学影像重点实验室,甘肃兰州730030

出　　处：《中国医学物理学杂志》2019年第3期296-300,共5页Chinese Journal of Medical Physics

基　　金：国家自然科学基金面上项目(811772006)

摘　　要：目的:通过与多田公式方法做比较,评估Picture Archiving and Communication Systems(PACS)系统三维测量方法测量脑出血体积的准确性。方法:这项回顾性研究纳入了165例急性脑出血患者,并采用36个体积不同、形态不同的不规则水模。均行常规CT扫描。两名影像医师分别使用两种方法独立测量水模及血肿体积,比较两种方法的差异性及准确性。差异性:按PACS三维测量体积将血肿大小分为5级(0～10.0mL、10.1～20.0mL、20.1～30.0mL、30.1～50.0mL、>50.1mL);按barras scale规则来将血肿形态分为5级,分别根据血肿大小和形状对两种方法测量结果进行分析比较。准确性:用两种方法测得水模体积与水模实际体积作比较;准确性验证:用两种测量方法测得的15例经微创手术病人的出血量与术后证实的实际出血量作对比。结果:当10.0mL<血肿体积≤30.0mL时,两种方法测得结果差异均无统计学意义(P>0.05);当血肿体积≤10.0mL或>30.0mL时,两种方法测量结果差异均有统计学意义(P<0.05);当血肿形态为1～3级时,两种方法测得血肿体积差异均无统计学意义(P>0.05);当血肿形态为4～5级时,两种方法测得血肿体积差异均有统计学意义(P<0.05)。PACS三维方法测得水模体积与实际体积差异无统计学意义(P=0.22),多田公式测量方法测得水模体积与实际体积差异有统计学意义(P=0.01);且PACS三维方法测得体积更接近实际水模体积及15例经微创手术证实的患者真实出血体积。结论:血肿体积过小(≤10mL)或过大(>30mL)时,两种方法测量差异较大;血肿形态越不规则,两种方法测量差异越大;PACS三维测量方法测量体积更接近真实体积。Objective To evaluate and compare the accuracies of Picture Archiving and Communication Systems (PACS) threedimensional measuring method and Tada formula in the measurement of intracerebral hemorrhage (ICH) volume. Methods A retrospective study was conducted on 165 patients with acute ICH. Thirty-six irregular water phantoms with different shapes and volumes were used in this study. All patients and water phantoms were scanned with conventional CT. Two imaging specialists used both Tada formula and PACS three-dimensional measuring method to measure the volumes of hematoma and water phantoms, independently. The differences and accuracies of the two methods in ICH volume measurement were compared. Based on the hematoma volume measured with PACS three-dimensional measuring method, the hematoma size was divided into 5 grades, namely 0-10.0 mL, 10.1-20.0 mL, 20.1-30.0 mL, 30.1-50.0 mL and >50.1 mL. According to the rule of barras scale, the hematoma shape was divided into 5 levels. The results obtained with the two methods were analyzed and compared from two aspects namely hematoma size and hematoma shape. The measurement accuracies of the two methods were evaluated by comparing the measured phantom volume with the actual phantom volume, and then verified by the comparison of the measured ICH volume in 15 patients treated with minimally invasive surgery and the actual ICH volume. Results When the hematoma volume was larger than 10.0 mL but less than 30.0 mL, no statistical differences were found between the two methods (P>0.05). When the hematoma volume was less than 10.0 mL or larger than 30.0 mL, the difference between the two methods was statistically significant (P<0.05).When the hematoma shape was level 1-3, no statistical differences were found between the two methods (P>0.05).When the hematoma shape was level 4-5, the difference in hematoma volume was statistically significant (P<0.05). There was no significant difference between the phantoms volume measured by PACS three-dimensional measuring method and the ac

关 键 词：脑出血量 多田公式 PACS系统三维测量 计算机断层扫描 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R318[医药卫生—临床医学]