计算机辅助检测系统对数字化胸片中肺结节诊断的应用价值

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

目的评价计算机辅助检测(computer aided detection,CAD)系统对肺内单发结节的诊断价值。方法选取150例直径约9～30mm肺部单发结节的病例为试验组,所有肺结节病灶均经病理证实。另从健康体检人群中数字法随机抽取150例年龄、性别构成与受检组相仿的病例作为对照组。2组胸部X线片均经CT证实,并由多名放射学专家共同诊断。所有胸部X线片均通过数字化X线摄影(digital radiography,DR)获得。由5名高年资影像诊断医生和5名低年资影像诊断医生作为观测者,分别对不用和用CAD系统输出图像的胸部X线片进行诊断。观察者积分用受试者操作特性曲线(receiver operating characteristic curve,ROC曲线)分析来衡量。结果高年资影像诊断医生评价的平均ROC曲线下面积从不用CAD系统输出图像(0.821±0.001)与用CAD系统输出图像(0.834±0.016)进行比较,两者差异有统计学意义(P<0.05),低年资影像诊断医生评价的平均ROC曲线下面积从不用CAD系统输出图像(0.711±0.022)与用CAD系统输出图像(0.831±0.022)进行比较,两者差异有统计学意义(P<0.05)。结论运用DR所配置的CAD系统能帮助影像诊断医生提高对肺结节性病灶的检出率。

Objective To determine the effect of computer aided detection system on the diagnosis of pulmonary nodules. Methods For examined patients, 150 cases with solitary lung nodules up to 9 - 30 mm in diameter were used. All nodules had been verified by means of biopsy. For healthy patients, 150 cases were selected as control group on the basis of confirmation on the chest CT. All chest radiograph in the two groups 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 was evaluated with receiver operating characteristic curve analysis. Results For the experienced chest radiologists, the average area under the curve value increased significantly from （0. 821 ±0. 001 ） to（0. 834 ± 0.016） with CAD output images. For the residents, the average area under the curve value increased significantly from （0. 711 ± 0. 022） to （0. 831 ± 0. 022） with CAD output images. Conclusion This CAD system for digital radiograph can assist radiologist and has the potential to improve the detection of lung nodules.