摘要
目的探讨低剂量胸部CT扫描联合计算机辅助检测肺结节（CAD）系统筛查肺癌高危人群肺内结节的临床价值和CAD系统对放射科医师的辅助作用。方法选取219名具有肺癌高危因素体检者，行低剂量胸部CT平扫，由2名具有15年以上胸部诊断经验的放射科高年资医师独立阅读1．0mm层厚重建图像，记录每例结节表现，两者意见一致后保留诊断结果作为金标准；应用CAD系统对上述图像进行结节识别处理并记录检出结果，另由2名具有5年影像诊断工作的放射科年轻医师阅读上述图像，记录诊断结果，然后应用CAD系统的输出结果再次阅读图像并记录诊断结果，根据金标准判断CAD系统检测肺结节的敏感性、假阳性率，应用x^2检验比较年轻医师应用CAD系统前后肺结节检测的能力。结果219名体检者中最终确定有结节者104（47．5％）名，高年资医师共确定366个结节为真结节。在366个真结节中，CAD系统检测到271个（74．0％，CAD系统共检测到695个结节，假阳性结节424个）；2名年轻医师未用CAD系统时分别检测到292（79．8％）和286个（78．1％）结节，应用CAD系统后分别检测到336（91．8％）和333个（91．0％）结节，年轻医师应用CAD系统前后肺结节检测的敏感性之间差异具有统计学意义（P〈0．01）。结论CAD系统对肺门区或中心区的结节检测敏感性较年轻医师高，年轻医师对周围区、胸膜下结节、磨玻璃密度结节、≤4mm结节的检测敏感性明显优于CAD系统，两者相互结合能够提高肺结节的检出率。
Objective To investigate the clinical value of chest low-dose CT （LDCT） combined with computer-aided detection （CAD） system for lung cancer screening in high risk population. Methods Two hundred and nineteen healthy candidates underwent 64-slice LDCT scan. All images were reviewed in consensus by two radiologists with 15 years of thoracic CT diagnosis experience. Then the image data were analyzed with CAD alone. Finally images were reviewed by two radiologists with 5 years of CT diagnosis experience with and without CT Viewer software. The sensitivity, false positive rate of CAD for pulmonary nodule detection were calculated. SPSS 11.5 software and Chi-square test were used for the statistics. Results Of 219 candidates ,104（47.5% ）were detected with lung nodules. There were 366 true nodules confirmed by the senior radiologists. The CAD system detected 271 （74. 0% ） true nodules and 424 falsepositive nodules. The false-positive rate was 1.94/per case. The two junior radiologists indentifid 292（79. 8% ）, 286（78. 1% ） nodules without CAD and 336 （91.8%） , 333 （91.0%） nodules with CAD respectively. There were significant differences for radiologists in indentifying nodules with or without CAD system （P 〈 0. 01 ）. Conclusions CAD is more sensitive than radiologists for indentifying the nodules in the central area or in the hilar region of the lung. While radiologists are more sensitive for the peripheral and sub-pleural nodules, or ground glass opacity nodules, or nodules smaller than 4 mm. CAD can not be used alone. The detection rate can be improved with the combination of radiologist and CAD in LDCT screen.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2010年第1期29-32,共4页
Chinese Journal of Radiology
基金
基金项目：北京市自然科学基金资助项目（7062020）
