相同分辨力不同品牌影像诊断显示器对孤立性肺结节识读的影响

Preliminary study of detection accuracy of single pulmonary nodules by using image diagnostic monitors with same resolution and different brand

目的:通过不同品牌间相同分辨力的影像诊断显示器对胸部数字化X线摄影(DR)肺结节检出准确率的比较,评价品牌之间显示器的诊断效能。方法:从图像存储与传输系统(PACS)数据库中搜寻本院2005年3月～2008年12月胸部DR中发现或可疑有肺结节者行CT检查,CT发现单发、直径≤30mm的结节,列为阳性组;而CT证实无结节者列入阴性组。5位医师分别应用三种品牌显示器用5分法:肯定有、可能有、不确定、可能无、肯定无,独立判断结节有无。利用识读结果绘制ROC曲线,并比较曲线下面积及各品牌显示器之间的诊断效能。结果:5位影像诊断医师在3个品牌显示器中对1～10mm组孤立性肺结节识读的总平均值分别为Az(A)=0.877±0.053,Az(B)=0.895±0.050,Az(C)=0.887±0.051,对10～30mm组孤立性肺结节识读的总平均值分别为Az(A)=0.891±0.045,Az(B)=0.901±0.044,Az(C)=0.892±0.045。所使用的三种显示器中,由于分辨力相同,3百万象素(3MP),从ROC曲线中可以看出,曲线下的面积Az虽然是有差别的,但都接近于0.9,说明3MP的液晶显示器(LCD)在孤立性肺结节的诊断效能是比较高的,其中品牌B的面积最大。经过统计学检验,P值有所不同。结论:3MP显示器在肺结节识读影像上差异具有统计学意义,但总的诊断效能无明显差异。

Objective：By use of image diagnostic monitors with different brand and same resolution to compare detection accuracy of pulmonary nodules on the chest digital radiography （DR） and to evaluate the brand diagnostic performance between the displays.Methods：From the picture archiving and communication system （PACS） the database were searched from March 2005-December 2008 of our hospital to find out patients with confirmed or suspicious lung nodules by chest DR for CT examination.Single nodule found by CT with diameter 〈30mm classified as the positive group and those with no nodules as the negative group.Five doctors used three brands of monitors with 5-grade method （definite,possible,uncertain,possibly not,certainly not） to judge independently whether there were nodules or not.ROC curves were drawn according to the reading results,areas under the curves and the diagnostic effectiveness of different brands were compared.Results：The average reading on 3 brands of displays in the 1～10mm group of solitary pulmonary nodules viewed by the 5 radiological doctors were Az （A）=0.877±0.053,Az （B）=0.895±0.050,Az （C）=0.887±0.051,respectively.Those in the 10～30mm group were Az （A）=0.891±0.045,Az （B）=0.901±0.044,Az （C）=0.892±0.045.Conclusion：Since the resolution of the three types of displays used was the same （3MP）,it can be seen from the ROC curve that Az areas under the curve,though they are different,are all close the 0.9,indicating that the diagnosis efficiency of LCD of 3MP for solitary pulmonary nodules is high,in which the area of Brand B is the greatest.By stastistical testing,P values are different.It can be drawn that 3MP display images had statistically significant difference in the readings of pulmonary nodules,but there is no difference in the effectiveness of diagnosis.