VolumeRAD容积成像对胸部病变的诊断价值

The value of VolumeRAD in the diagnosis of thoracic lesions

目的评价VolumeRAD容积成像对X线胸片上可疑肺病变的诊断价值。方法 162例[男89例,女73例,平均年龄(56.1±12.5)岁]可疑有肺病变的患者在进行了最初的胸部X线平片分析后进行了VolumeRAD成像。两名医师(分别有4年和30年工作经验)在PACS工作站上独立对胸部X线平片和VolumeRAD图像进行分析,并对每个病灶提出诊断置信度。胸部CT作为参考标准。结果共对178个病灶进行鉴别。在55例患者中,VolumeRAD成像和CT没有发现任何病灶。在余下的107例患者中,发现了121个病灶,包括82个肺内病灶和39个肺外病灶。胸部X线平片与VolumeRAD成像诊断准确度不同(阅片者1分别为47.75%和91.01%;阅片者2分别为51.12%和92.70%;P<0.05),由ROC曲线下面积所得的置信度也不同(阅片者1分别为0.799和0.948;阅片者2分别为0.831和0.973;P<0.05)。结论 VolumeRAD容积成像提高了X线胸片上可疑病灶的诊断准确度和置信度。

Objective To evaluate the value of VolumeRAD in the diagnosis of suspected pulmonary lesions on chest radiography.Methods One-hundred sixty-two patients(89 men,73 women;mean age,56.1 ± 12.5 years) with suspected pulmonary lesions after initial analysis of chest radiography underwent VolumeRAD.Two independent readers(with 4 and 30 years of experience) prospectively analyzed the chest radiographic and VolumeRAD images on a PACS System workstation and proposed a diagnostic confidence score for each lesion.Chest computed tomography was the reference standard examination.Results A total of 178 suspected pulmonary lesions were identified.In 55 patients,VolumeRAD and CT did not confirm any lesion.In the remaining 107 patients,121 lesions were identified,including 82 pulmonary and 39 extrapulmonary lesions.Chest radiography versus VolumeRAD differed in accuracy(reader 1,47.75% vs.91.01%;reader 2,51.12% vs.92.70%;P < 0.05) and confidence by area under the receiver-operating characteristic curve(reader 1,0.799 vs.0.948;reader 2,0.831 vs.0.973;P < 0.05).Conclusions VolumeRAD improve diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography.