不同显示矩阵影像诊断工作站识读肺部小结节的初步研究  

Preliminary study of diagnostic workstation with different matrix size for detection of small pulmonary nodules

作　　者：吴杰[1] 王学建[1] 王波[1] 童娟[1] 魏渝清[1] 沈桂权[1] 王丽梅[1] 曹军[1] 眭贺[1] 

机构地区：[1]贵阳医学院附属医院放射科,550004

出　　处：《中华放射学杂志》2004年第3期295-300,共6页Chinese Journal of Radiology

摘　　要：目的　评价不同显示矩阵的影像诊断工作站对识读肺部小结节的影响。方法　选取76张计算机摄影 (CR)胸片 ,其中 36张含有CT证实的直径 <2cm的小结节 ,分为 1 0～ 2 0cm及<1 0cm 2组。 3位诊断医师分别在 1K、2K显示器和数字会诊系统的投影屏幕上识读胸片影像 ,用5分法 :肯定有、可能有、不确定、可能没有、肯定没有 ,独立判断结节存在与否。绘制受试者操作特性(ROC)曲线 ,计算每位医师分别在 1K和 2K的影像诊断工作站及数字会诊系统上识读直径 1 0～2 0cm及 <1 0cm 2组肺部小结节的ROC曲线下的面积 (AZ 值 )及标准误 [s x(AZ) ],并进行比较。结果　 3位诊断医师在数字会诊系统、1K及 2K显示器下检测肺部小结节的平均ROC的AZ 值分别为 :直径 1 0～ 2 0cm组 :0 7936、0 82 2 5、0 836 7;<1 0cm组 :0 6 6 98、0 6 998、0 72 32。随着显示器分辨率的提高 ,AZ 值随之提高 ,但是经ROC分析 ,不同观片系统的检测效能差异无显著性意义 (P>0 5 )。结论　用 1K显示器、数字影像会诊系统加用影像后处理 ,特别是放大功能 ,识读肺部直径≥ 1 0cm的小结节是可以的 ,识读肺部 <1 0cm的小结节宜采用 2K× 2K高分辨率工作站。不同显示矩阵的观片系统的合理配置 ,可获得较好的性价比及保证诊断准确性。Objective To assess the influence in detecting small pulmonary nodules (SPNs) on soft-copy images displayed with different matrix sizes.Methods Seventy-six chest compute radiographs were selected for the study.Of the 76 test images,36 pulmonary nodules smaller than 20 mm in diameter were proven by CT,which were further divided into two groups: 1.0-2.0 cm and <1.0 cm in diameter.Soft-copy images displayed with 1 K monitor,2 K monitor,and digital radiology conference system (DRCS) were evaluated respectively by three radiologists.The presence or absence of SPNS were investigated with a five-point confidence-rating scale:(1) definitely positive; (2) probably positive; (3)indeterminate; (4) probably negative; and (5) definitely negative.ROC curves for each radiologist were drawn,then compared with the A Z values and standard error of three kinds of view system for individual observers. Results For 1.0-2.0 cm group,the mean A Z values were 0.7936 for DRCS with 2-fold magnification and window technique,0.8225 for 1 K monitor with 2-fold magnification and window technique,and 0.8367 for 2 K monitor without magnification; for <1.0 cm group,0.6698 for DRCS,0.6998 for 1 K monitor,and 0.7252 for 2 K monitor.The A Z values increased slightly as the display matrix size improved,but there were no significant differences among the three sets in the detection of SPNS in the ROC analyses.Conclusion It is acceptable to detect small pulmonary nodules of 1.0～2.0 cm in diameter on 1 K monitor and DRCS with magnification.High resolution diagnostic workstation is recommended for detecting small pulmonary nodules <1.0 cm in diameter.Reasonable equipment for the detection of subtle abnormality may result in better cost-efficacy and diagnostic accuracy.

关 键 词：肺部小结节 ROC曲线 肺硬币病变 影像诊断 

分 类 号：R816.4[医药卫生—放射医学]