计算机辅助诊断在诊断GardenⅠ、Ⅱ型股骨颈骨折中应用价值

Applied Value of Computer-aided Diagnosis in the GardenⅠ, ⅡTypes of Femoral Neck Fractures

[目的]探讨自主研发的计算机辅助诊断(computer-aided diagnosis,CAD)系统在平片诊断GardenⅠ、Ⅱ型股骨颈骨折中的应用价值。[方法]筛选2010年01月至2013年10月期间确诊的GardenⅠ、Ⅱ型股骨颈骨折307例患者作为研究对象,骨折分别由CAD软件、初级影像科医生和有经验影像科医生单独作出诊断,然后由初级和有经验影像科医生联合CAD作出诊断,对诊断符合率行统计学分析。[结果]在307例患者中CAD独立诊断符合率77.9%,显著低于有经验医生的94.5%(P<0.001),略低于初级医生的81.4%(P>0.05);联合CAD后初级医生和有经验医生诊断符合率均显著提高(P<0.001,P<0.05)。在GardenⅠ型143例、Ⅱ型164例中,CAD独立诊断符合率分别为71.3%、83.5%,略低于初级医生(P>0.05),显著低于有经验医生(P<0.001);联合CAD后初级医生诊断符合率均显著提高(P<0.001),而有经验医生诊断符合率提高均不明显(P>0.05)。[结论]基于股骨颈骨折的CAD软件有助于提高影像科医生对GardenⅠ、Ⅱ型骨折的检出率,尤其是初级影像科医生。

[Objective]To investigate the applied value of the self-developed computer-aided diagnosis（CAD） in the Garden Ⅰ,Ⅱ type femoral neck fracture on plain film.[Methods]307 patients with Garden],Ⅱ types femoral neck fracture during from January 2010 to October 2013 were treated as the research object,the fractures were respectively made diagnosis by the CAD software,primary and experienced radiologists,and the primary and experience radiologists combined diagnosis with CAD,the diagnosis accordance rate of them was statistically analysed.[Results] In 307 cases,the CAD diagnosis accordance rate of 77.9%,was significandy lower than 94.5% of the experienced radiologist（P〈0.001）,but slightly lower than the 81.4% of junior radiologist（P〉0.05）; the diagnosis accordance rate of junior radiologist and experienced radiologist was significantly improved after combined diagnosis with CAD（P〈0.001,P〈0.05）.In the Garden [type with 143 cases,type Ⅱ with 164 cases,the CAD independent diagnostic rates of 71.3%,83.5%,were slighdy lower than that of junior radiologist（P〉0.05）,but significantly lower than that experienced radiologist（P〈0.001）; but the junior radiologist diagnosis accordance rate was significandy improved after combined diagnosis with CAD（P〈0.001）,however,that of experienced radiologist was not obviously increased（P〉0.05）.[Conclusion]The CAD software based on the femoral neck fracture helps to improve radiologists detection rate to Garden Ⅰ,Ⅱ fracture,especially junior radiologists.