不同年资医师对肺间质纤维化胸膜及肺超声征象判读一致性研究  

Study on the Consistency of the Interpretation of Pulmonary Interstitial Fibrosis Pleural and Lung Ultrasound Signs by Sonographers of Different Seniorities

作　　者：王晓娜[1] 赵浩天[1] 侯丽鹏 牛慧敏[1] 薛红元[1] 李丽[1] Wang Xiaona;Zhao Haotian;Hou Lipeng;Niu Huimin;Xue Hongyuan;Li Li(Department of Ultrasound,Hebei General Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院超声科,石家庄市050000

出　　处：《中国超声医学杂志》2024年第3期333-336,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河北省医学科学研究计划项目(No.20210443、20211264)。

摘　　要：目的 探讨不同年资医师对肺间质纤维化胸膜及肺超声征象判读一致性,并探讨其临床意义。方法 选择CT确诊肺间质纤维化的20例患者的完整十二分区检查的肺超声图像480张(240张肺声场图像、240张胸膜超声图像)。将6名不同年资超声医师分为高年资组、中年资组和低年资组,分别对图像进行判读,分析其一致性。结果 肺超声B线评分的组内一致性:高年资组内Kappa值分别为0.934、0.758、0.799、0.948(P<0.05);中年资组内Kappa值分别为0.871、0.676、0.708、0.800(P<0.05);低年资组内Kappa值分别为0.821、0.553、0.617、0.693(P<0.05);胸膜超声评分的组内一致性:高年资组内Kappa值分别为0.917、0.754、0.806、0.947(P<0.05);中年资组内Kappa值分别为0.919、0.617、0.611、0.823(P<0.05);低年资组内Kappa值分别为0.791、0.556、0.651、0.809(P<0.05);6名不同年资医师对肺超声B线及胸膜评分结果一致性水平很高,Kendall W系数分别为0.830、0.919(P<0.05)。结论 不同年资超声医师对肺间质纤维化的超声图像整体判读一致性较好,但低年资组医师对1分的B线和1分的胸膜判读一致性中等,应加强该部分病例的读图学习。Objective To investigate the consistency of the interpretation of pulmonary interstitial fibrosis pleural and lung ultrasound signs by sonographers of different seniorities,and to explore its clinical significance.Methods A total of 480 lung ultrasound images of 20 patients with CT confirmed pulmonary interstitial fibrosis(240 lung acoustic field images and 240 pleural ultrasound images) were selected for the complete 12-zone examination.6 sonographers with different seniorities were divided into high-seniority group,middle-seniority group and low-seniority group.The images were interpreted separately to analyze the diagnostic consistency of the 3 groups.Results Intra-group consistency of lung ultrasound B-line scores:Kappa in the high-seniority group were 0.934,0.758,0.799,and 0.948 respectively(all P<0.05);Kappa in the middle-seniority group were 0.871,0.676,0.708,and 0.800 respectively.(all P<0.05);the Kappa in the low-seniority group were 0.821,0.553,0.617,and 0.693 respectively(all P<0.05).The intra-group consistency of pleural ultrasound scores:the Kappa in the high-seniority group were 0.917,0.754,0.806,0.947(all P<0.05);the Kappa in the middle-seniority group were 0.919,0.617,0.611,and 0.823 respectively(all P<0.05);the Kappa in the low-seniority group were 0.791,0.556,0.651 and 0.809,respectively(all P<0.05).Six physicians with different seniorities had a high level of agreement on the results of lung ultrasound B-line and pleural score,the Kendall W coefficients were 0.830 and 0.919,respectively(all P<0.05).Conclusions The overall interpretation of ultrasound images of pulmonary interstitial fibrosis by sonographers of different seniorities is good,but the consistency of interpretation of B-line of 1 and pleura of 1 by sonographers in the low-seniority group is modest,and the reading of these cases should be strengthened.

关 键 词：肺超声 肺间质纤维化 一致性 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]