常规DR胸片对肺结节漏诊原因的分析

The Analysis of Conventional DR Chest Film Misdiagnosed to Pulmonary Nodules

为了探讨常规DR后前位胸片对肺结节漏诊的原因,对136例多层螺旋CT扫描发现有肺结节患者,行常规DR后前位胸片检查,确定常规DR胸片上肺结节漏诊的原因。结果显示常规DR胸片检出104例,32例未检出的肺结节平均直径(15.0±7.4)mm,肺结节的大小对肺结节的检出差异显著,有统计学意义(P<0.01)。2例肺结节CT片上呈磨玻璃样密度。其中15例位于肺的隐蔽性区域。因此,直径较小、密度较低及位于肺隐蔽区域的结节容易在常规后前位DR胸片上漏诊。

To investigate the reasons why some pulmonary nodules were misdiagnosed on the conventional posteroanterior digital radiography（DR） chest film. 136 patients with pulmonary nodules on the multiple detector computer tomography（MDCT） were reviewed, all these patients underwent the normal posteroanterior digital radiography chest film, the results were performed by 2 radiologists independently. When consistency was obtained among the independent results, the diagnosis of missed diagnosis pulmonary nodules could be confirmed. Compared with the reference results from MDCT, the reasons why some pulmonary nodules were misdiagnosed on the conventional posteroanterior DR chest film would be analyzed. Among a total of 136 sites pulmonary nodules detected on MDCT, 104 sites were also could be found on the conventional posteroanterior DR chest film, the mean diameter of the 32 sites misdiagnosed is 15 ± 7.4mm, a significant statistically difference was found between the diameter of the missed diagno- sis pulmonary nodules and the detection rate on the normal posteroanterior DR chest film （P〈0. 01）, 2 sites were displayed as frosted glass on MDCT, 15 sites missed diagnosis were in the lung crypticity compass. Therefore, the pulmonary nodules that have small diameters and low density and some which are at the compass of the lung could be easily missed diagnosis on the conventional posteroanterior DR chest film.