计算机辅助检测系统（CAD）在16层CT低剂量肺癌筛查肺结节检出中的应用价值

Application of Computer-aided Detection System(CAD) in the Screening of Lung Nodules in 16-slice CT Low-dose Lung Cancer

目的研究探讨计算机辅助检测系统(computer-aided detection,CAD)在16层计算机断层扫描(computed tomography,CT)低剂量肺癌筛查肺结节检出中的应用价值。方法选择我院140例疑似肺癌患者(2017年1月至2018年12月),采用16层螺旋CT机对患者实施低剂量螺旋CT检查,分别采取人工阅片、CAD阅片、联合阅片,比较人工阅片与CAD阅片的判读时间。以穿刺活检病理诊断结果为参照,计算不同判读方法对肺癌的诊断灵敏度、特异度、准确率,分析不同判读方法判读结果与穿刺活检病理诊断结果之间的一致性,并比较不同判读方法对肺癌患者肺结节大小的诊断符合率。结果CAD阅片的判读时间较人工阅片缩短,P<0.05。以穿刺活检病理诊断结果为参照,联合阅片对肺癌的诊断灵敏度、特异度、准确率均高于人工阅片、CAD阅片(P<0.05)。联合阅片与穿刺活检病理诊断结果之间的一致性良好,而人工阅片、CAD阅片与穿刺活检病理诊断结果之间的一致性中等。联合阅片对肺癌患者肺结节大小的诊断符合率较人工阅片、CAD阅片更高(P<0.05)。结论CAD用于低剂量CT肺癌筛查中,与影像科医师阅片相结合,可有效提高对肺结节的检出率,有利于提高肺癌筛查的准确性。

Objective To study the computer-aided detection system (CAD) in 16-layer computed tomography (CT).The value of CT in the screening of lung nodules in low-dose lung cancer.Methods 140 patients with suspected lung cancer (from January 2017 to December 2018) were selected,and the low-dose spiral CT was performed on the patients with 16-slice spiral CT.The time of interpretation of artificial reading and CAD reading was compared.the diagnostic sensitivity,the specificity and the accuracy of the different interpretation methods on the lung cancer are calculated by taking the pathological diagnosis result of the puncture biopsy as a reference,and the consistency between the interpretation result of the different interpretation method and the pathological diagnosis result of the puncture biopsy is analyzed,And the diagnostic accuracy of different interpretation methods on the lung nodule size of the lung cancer patient is compared.Results The interpretation time of the CAD reading piece was shorter than that of the manual reading piece,P <0.05.The diagnostic sensitivity,specificity and accuracy of the combined test piece for lung cancer were higher than that of manual reading and CAD (P <0.05).The consistency between the results of the pathological diagnosis of the combined reading piece and the puncture biopsy is good,and the consistency of the artificial reading piece,the CAD reading piece and the pathological diagnosis result of the puncture biopsy is moderate. The coincidence rate of the diagnosis of lung nodules in patients with lung cancer was more than that of the manual reading,and the CAD reading was higher (P <0.05).Conclusion CAD is used in the screening of low-dose CT lung cancer,which can improve the detection rate of lung nodules and improve the accuracy of lung cancer screening.