传统与数字化X线摄影检出肺部小结节的ROC曲线评价

目的对比传统和直接数字化X线摄影对肺部小结节(≤2 cm)检出的诊断价值.方法选取经证实的肺部非钙化结节和无肺部结节的健康体检病例各90例,分别摄取正位传统胸片和数字化胸片,由高低年资医生分别进行观察评分,结果用ROC曲线法分析.结果总体数字化胸片组ROC曲线下面积(Az值)显著大于传统胸片组(t＝2.726,P＝0.034).隐蔽部位肺结节显示数字化胸片组Az值显著大于传统胸片组(t＝3.606,P＝0.011).6组不同大小病灶均显示数字化胸片组Az值大于传统胸片组,其中前三组(3～5 mm,6～8 mm,9～11 mm)有统计学显著性差异(P＜0.05).结论数字化胸片在发现肺部小结节病灶,尤其在检出肺隐蔽部位结节和肺微小结节方面,明显优于传统胸片.

Comparison of digital radiography and conventional X-ray in the detection of small pulmonary nodule with receiver operating characteristic curve analysis

Objective To compare digital radiographs with conventional radiographs in the detection of small pulmonary nodules. Methods The study had 90 cases with small pulmonary nodule and 90 controls. The cases had been confirmed by chest computed tomography and videofluoroscopy. All cases examined by both digital radiography and conventional radiography were reviewed by senior and junior doctors. Assessment was analyzed by receiver operating characteristic curve (ROC). Results For all, observer performance in digital radiographs was superior to that in conventional radiographs ( t = 2.726 , P =0.034). In the detection of hidden pulmonary nodules,observer performance in digital radiographs was superior to that in conventional radiographs ( t =3.606, P =0.011). For six size groups,observer performance in digital radiographs was superior to that in conventional radiographs,and there was statistical difference in the detection of 3-5 mm, 6-8 mm, 9-11 mm pulmonary nodules ( P <0.05). Conclusion Digital radiographs is superior to conventional radiographs in the detection of small pulmonary nodules, specially hidden pulmonary nodules and pulmonary micro-nodules.