摘要
目的分析基于GBZ70-2015标准误判尘肺分期的影响因素。方法回顾性纳入65例尘肺,由副主任医师、主治医师及住院医师各1名独立基于胸部高分辨率CT判断尘肺分期,观察结果的一致性;以由5名专家采用Delphi法所获尘肺分期结果为金标准,分析误判尘肺分期的影响因素。结果65例尘肺中,1期42例、2期16例、3期7例。观察者间判断尘肺分期结果的一致性较强(Kappa=0.653),其对3期尘肺的判断结果的一致性最佳(Kappa=0.803)、1期次之(Kappa=0.661)而2期最低(Kappa=0.518)。医师资历低(OR=4.872),病灶主要分布于肺上叶尖后段(OR=2.317),存在r型小阴影(OR=3.105)及CT肺气肿指数高(OR=1.214)均为误判尘肺分期的独立影响因素(P均<0.05)。结论阅片医师资历及病灶异质性均为基于GBZ70-2015标准误判尘肺分期的主要影响因素。
Objective To explore the impact factors of misjudge of pneumoconiosis stage based on GBZ70-2015 criteria.Methods Sixty-five case of pneumoconiosis were retrospectively enrolled.Chest high-resolution CT were independently analyzed by one associate chief physician,one attending physician and one resident physician,respectively.The stage of pneumoconiosis was judged,and the inter-observer consistency was observed.Taken the results of 5 experts using Delphi method as gold standard,the impact factors of misjudge of pneumoconiosis stage were analyzed.Results Among 65 cases,there were 42 cases of stage 1,16 cases of stage 2 and 7 cases of stage 3 pneumoconiosis.The inter-observer consistency of pneumoconiosis stage was relatively high(Kappa=0.653),of stage 3 pneumoconiosis was the best(Kappa=0.803),followed by stage 1(Kappa=0.661),while of stage 2 was the lowest(Kappa=0.518).Radiologist lack experience(OR=4.872),the lesions mainly located in the posterior upper area of lungs(OR=2.317),the present of r-type small shadows(OR=3.105)and high CT pulmonary emphysema index(OR=1.214)were all independent impact factors of misjudge of pneumoconiosis stage(all P<0.05).Conclusion Both the experience of radiologist and lesions'heterogeneity were main impact factors of misjudge of pneumoconiosis stage based on GBZ70-2015 criteria.
作者
刘亚
季鹏
曾敏
周思静
周斌
LIU Ya;JI Peng;ZENG Min;ZHOU Sijing;ZHOU Bin(Department of Imaging Center,the Third People's Hospital of Hefei,Hefei 230022,China;Department of Occupational Disease,the Third People's Hospital of Hefei,Hefei 230022,China)
出处
《中国介入影像与治疗学》
北大核心
2025年第8期525-528,共4页
Chinese Journal of Interventional Imaging and Therapy
基金
合肥市第三人民医院2021年度院级重点科研项目(SYKF202104)
合肥市第七周期临床重点(培育)专科建设项目。
