三种方法计算气胸CT影像的肺萎陷程度比较  

Comparison of three methods for calculating lung compression degree in CT images of pneumothorax

作　　者：江洁清[1] 王远军[2] 汪葛 冯朝英 高丰 陆靖 杨凯 Jiang Jieqing;Wang Yuanjun;Wang Ge;Feng Chaoying;Gao Feng;Lu Jing;Yang Kai(Department of Forensic Medicine,School of Basic Medical Sciences,Fudan University,Shanghai 200032;University Of Shanghai For Science And Technology,Shanghai 200433;HuaDong Hospital Affiliated to Fudan University,Shanghai,200040;The Sixth Affiliated Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200233)

机构地区：[1]复旦大学基础医学院法医学系,上海200032 [2]上海理工大学,上海200433 [3]复旦大学附属华东医院影像科,上海200040 [4]上海交通大学医学院附属第六人民医院影像科,上海200233

出　　处：《中国法医学杂志》2020年第2期173-176,181,共5页Chinese Journal of Forensic Medicine

摘　　要：目的探讨临床经验法、手工边界勾画法和软件自动分析法在基于CT影像的气胸致肺萎陷程度计算上的优劣,从而推荐一种客观科学高效的肺萎陷程度计算方法。方法通过三种方法分别计算54例气胸患者的肺萎陷百分比,比较三种方法在计算效率、结果的相关性、准确性、稳定性等方面的差异。结果临床经验法、软件自动分析法与目前公认的手工边界勾画法的结果间存在线性相关(P<0.01),软件自动分析法的准确性更高;在5级及3级分类法中,三种方法之间存在显著一致性,软件自动分析法与手工边界勾画法在百分比判定上的一致性更好;单侧气胸的肺萎陷百分比的一致率高于双侧气胸;同时,软件自动分析法在计算结果的高效性、稳定性等方面具有优势。结论软件自动分析法可以解决现有CT影像的肺萎陷程度计算方法中效率低和稳定性欠佳的问题,且具有准确性高、可操作性强的特点,适合在法医临床实践中广泛应用。Objective To explore the advantages and disadvantages of clinical experience method, manual boundary delineation method and software automatic analysis method in calculating the degree of pneumothorax induced lung compression based on CT images, so as to provide an objective, scientific and efficient method for calculating the degree of lung compression. Methods The percentage of lung compression in 54 patients with pneumothorax were calculated by three methods, and the differences in calculation efficiency, correlation, accuracy and stability of the three methods were compared. Results There is a linear correlation between the clinical experience method, the software automatic analysis method and the currently accepted manual boundary delineation method(P<0.01). The accuracy of software automatic analysis method is higher;There is a significant consistency between the methods in five-level taxonomy and three-level taxonomy, The software automatic analysis method and manual boundary delineation method have better consistency in percentage determination;In the calculation of lung collapse percentage of unilateral pneumothorax, the consistency rate is higher than that of bilateral pneumothorax;Meanwhile, compared with the other two methods, the software automatic analysis method has advantages in terms of efficiency and stability of the calculation results. Conclusion The software automatic analysis method can solve the problem of low efficiency and poor stability in calculating the degree of lung compression based on CT images, and it has high accuracy and operability, and is suitable for wide application in forensic clinical practice.

关 键 词：法医学 肺萎陷 图像处理 气胸 损伤程度鉴定 

分 类 号：DF795.1[医药卫生—法医学]