人工智能在早期胸部CT肋骨骨折的临床应用价值及局限性分析  

Clinical Application Value and Limitation Analysis of Artificial Intelligence in Early Thoracic CT for Rib Fractures

作　　者：李秀涛 谭理连[1] 邱绍清 文武成 林建真 Li Xiu-tao;TAN Li-Lian;QIU Shao-qing;WEN Wu-cheng;LIN Jian-zhen(Department of Radiology,The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong Province,China)

机构地区：[1]广州医科大学附属第二医院放射科,广东广州510260

出　　处：《中国CT和MRI杂志》2023年第10期115-118,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨人工智能(artificial intelligence,AI)辅助下医师在早期胸部CT肋骨骨折的检测能力、肋骨骨折的分布特点及隐匿性骨折的比例。方法203例患者接受早期胸部CT和随访CT检查。早期胸部CT进行常规检测法和三种检测方法检测肋骨骨折,以两次CT影像结果作为参照金标准,分析三个年龄段、四个部位、三种骨折类型的检出率,分析漏诊肋骨骨折的特征。结果共检出781处骨折。常规检测法肋骨骨折的诊断准确度92.3%,三种检测方法中AI+医师的诊断准确度96.0%,AI+医师在年轻组检出率最高(100%),医师+审核对中年组检出率最高(96.1%),AI+医师在肋骨各段具有非常高的检测能力。常规检测法和三种检测方法对移位骨折有较高检出率。肋骨骨折漏诊大部分为隐匿性骨折,且在明确骨折邻近区域。结论医师在AI辅助下能提高肋骨骨折诊断准确度,漏诊骨折多为隐匿性骨折,常在明确骨折邻近区域。Objective To investigate the ability of physicians assisted by Artificial intelligence(AI)to detect rib fractures in early chest CT,the distribution characteristics of rib fractures and the proportion of occult fractures.Methods 203 patients underwent both early chest CT and follow-up CT were enrolled.For early chest CT examination,the detection of rib fractures was divided into routine detection method and three detection methods.The detection rates of three age groups,four rib parts and three fracture types were calculated,and the characteristics of missed rib fractures were analyzed,based on the imaging results of the twice CT examinations as the reference standard.Results A total of 781 fractures were confirmed.The overall detection rate of rib fractures in the routine detection was 92.3%.The diagnostic accuracy of AI+radiologists was 96.0%.The detection rate of AI+radiologists was the highest in the young group(100%),and the detection rate of physician+reviewer was the highest in the middle-aged group(96.1%).The AI+radiologists has a very high detection ability in all segments of the rib.Two assessments of detection rate in displaced fracture were higher.Most missed rib fractures are occult fractures in the immediate vicinity of the defined fracture.Conclusion Most missed rib fractures are occult on early CT,which is in the vicinity of definite fractures.AI-assisted radiologists can improve the diagnostic accuracy of rib fractures.

关 键 词：人工智能 早期CT 肋骨 骨折 

分 类 号：R683.1[医药卫生—骨科学] R814.42[医药卫生—外科学]