数字化X线胸片计算机辅助检测在肺结节诊断中的应用价值

The value of computer aided detection in digital chest radiograph on the diagnosis of pulmonary nodules

目的:评价计算机辅助检测(CAD)系统对肺结节诊断的价值。方法:选取120例有肺部单发结节(直径9～30mm)的患者,所有肺结节病灶均经病理证实。另从健康体检人群中随机抽取120例年龄、性别与受检组相仿者作为对照组。两组患者均经CT证实,并由多位放射学专家共同诊断。所有X线胸片均通过数字化放射成像(DR)获得。由5名高年资和5名低年资影像医师作为观测者,分别对不用和用CAD输出图像的X线胸片进行诊断。观察者积分用受试者操作特性(ROC)曲线分析来衡量。结果:平均ROC曲线下面积从不用CAD输出图像的0.762增加至用CAD输出图像的0.825(P<0.05),在使用CAD输出图像时,低年资影像医师比高年资影像医师的平均ROC曲线下面积增加更多。结论:运用数字化X线胸片所配置的CAD系统,能帮助影像诊断医师提高对肺结节性病灶的检出率。

Objective:To evaluate the computer aided detection system on the diagnosis of pulmonary nodules. Methods: 120 cases of examined patients with solitary lung nodules up to 9-30 mm in diameter were evaluated. All nodules had been verified by means of biopsy. 120 cases of healthy patients were selected as control group on the basis of confirmation on the chest CT. All chest radiograph in the two group were obtained with a digital radiography system. Five experienced chest radiologists and five residents detected the chest radiograph with or without CAD output images. The scales of performance were evaluated with receiver operating characteristic curve(ROC curve). Results: The average area under the curve value increased significantly from 0.762 without to 0.825 with CAD output images(P<0.05). Individually, the use of CAD output images was more beneficial to radiology residents than to experienced radiologist. Conclusion: This CAD system for digital chest radiograph can assist radiologist and has the potential to improve the detection of lung nodules.