人工智能辅助CT诊断肝脏肿瘤与病理活检穿刺的一致性研究  

Study on consistency between artificial intelligence assisted CT diagnosis of liver tumors and pathological biopsy puncture

作　　者：杨磊[1,2] 陈宽 陈丹丹 YANG Lei;CHENG Kuan;CHENG Dan-dan(Radiology Department,Hubei Provincial Hospital of Traditional Chinese Medicine(Wuhan,430074),China;不详)

机构地区：[1]湖北省中医院放射科,湖北武汉430074 [2]湖北中医药大学附属医院 [3]湖北省中医药研究院放射科 [4]上海联影智能医疗科技有限公司联影医疗武汉总部

出　　处：《中西医结合肝病杂志》2023年第11期1022-1025,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：湖北省中医院(湖北中医药大学附属医院、湖北省中医药研究院)院内项目(No.2021YJKT-19)。

摘　　要：目的:分析人工智能(AI)辅助CT诊断肝脏肿瘤与病理活检穿刺的一致性。方法:2021年2月至2023年2月就诊的肝脏肿瘤患者70例,均给予多层螺旋CT(MSCT)检查,由2名工龄10年以上的放射科医生阅片后给出诊断结果,结合AI技术辅助阅片,重新给出诊断结果,将病理活检穿刺诊断结果作为该研究金标准,比较人工阅片、AI辅助阅片诊断准确率、灵敏度、特异度,Kappa检验人工阅片、AI技术辅助阅片与病理活检穿刺诊断的一致性。比较人工阅片、AI辅助阅片对直径>10 mm、≤10 mm肿瘤检出率,比较良、恶性肝脏肿瘤CT灌注参数[毛细血管通透性(PS)、肝血流(HBF)、平均通过时间(MTT)、肝血容量(HBV)、肝动脉灌注量(HAF)]。结果:AI辅助阅片诊断准确率(95.71%)、灵敏度(96.72%)均高于人工阅片(77.14%、77.05%),P<0.05;AI辅助阅片诊断特异度(88.89%)与人工阅片(77.78%)比较差异无统计学意义(P>0.05);Kappa检验AI技术辅助阅片与手术病理诊断的一致性较好(Kappa值=0.789),人工阅片与手术病理诊断的一致性一般(Kappa值=0.737)。AI辅助阅片对直径>10 mm肿瘤检出率(75.00%)与人工阅片(85.00%)比较差异无统计学意义(P>0.05),AI辅助阅片对直径≤10 mm肿瘤检出率(96.67%)高于人工阅片(43.33%),P<0.05。恶性组PS、HBF、HBV、HAF均高于良性组(P<0.05),恶性组MTT低于良性组(P<0.05)。结论:AI技术辅助MSCT可提高对肝脏肿瘤的诊断准确率、灵敏度,与病理活检穿刺诊断结果一致性较高,MSCT还可提供血流参数,辅助临床对肿瘤良、恶性作出鉴别诊断。Objective:To analyze the consistency between artificial intelligence(AI)assisted CT diagnosis of liver tumors and pathological biopsy puncture.Methods:A total of 70 patients with liver tumors treated in our hospital from February 2021 to February 2023 were selected for multi-slice spiral CT(MSCT)examination.Two radiologists with more than ten years of experience were given the diagnostic results after reviewing the radiographs,and the diagnostic results were given again with the aid of AI technology.The results of pathological biopsy and puncture diagnosis were taken as the gold standard for this study.The diagnostic accuracy,sensitivity,and specificity of manual film reading and AI-assisted film reading were compared,and the consistency of manual film reading and AI-assisted film reading with pathological biopsy puncture diagnosis was tested by Kappa.The detection rates of tumors with diameters>10 mm and≤10 mm were compared between manual radiography and AI-assisted radiography,and the CT perfusion parameters of benign and malignant liver tumors[capillary permeability(PS),hepatic blood flow(HBF),mean transit time(MTT),hepatic blood volume(HBV),hepatic artery perfusion volume(HAF)]were compared.Results:The diagnostic accuracy(95.71%)and sensitivity(96.72%)of AI-assisted film reading were higher than those of manual film reading(77.14%and 77.05%),P<0.05.The diagnostic specificity of AI-assisted film reading(88.89%)was higher than that of manual film reading(77.78%),P>0.05.Kappa test AI-assisted film reading had good consistency with surgical pathologic diagnosis(Kappa value=0.789),while manual film reading had little consistency with surgical pathologic diagnosis(Kappa value=0.737).The detection rate of tumors with diameters>10 mm with AI-assisted reading was 75.00%compared with that with manual reading(85.00%),P>0.05.The detection rate of tumors with diameters<10 mm with AI-assisted reading was 96.67%higher than that with manual reading(43.33%),P<0.05.Also,the index of PS,HBF,HBV,and HAF in malignant group were

关 键 词：肝脏肿瘤 人工智能 多层螺旋CT 病理活检穿刺 

分 类 号：R445[医药卫生—影像医学与核医学]