隐蔽的肺部小结节病灶的X线诊断传统与数字化摄影的ROC评价

目的 :对比研究数字化X线摄影和传统X线摄影对发现与正常解剖结构重叠的肺部小结节病灶的诊断价值。方法 :选取 3 0例经手术病理证实的肺部结节病例和 3 0例经CT证实无肺部结节的病例 ,分别摄取传统胸片 (A组 )和数字化胸片 (B组 ) ,由 4位高年资医生和 4位低年资医生分别对以上 60对胸片进行观察 ,结果采用ROC曲线统计法进行统计。结果 :对高年资医生来说 ,数字化胸片 (B组 )得到的ROC曲线下面积 (Az =0 .83 7)大于传统胸片 (Az =0 .82 3 ) ,两者有统计学显著性差异 (P <0 .0 5 ) ;对低年资医生来说 ,数字化胸片 (B组 )得到的ROC曲线下面积 (Az =0 .842 )大于传统胸片 (Az =0 .717) ,两者有统计学显著性差异 (P <0 .0 5 ) ;对所有医生来说 ,数字化胸片 (B组 )得到的ROC曲线下面积 (Az =0 .840 )大于传统胸片 (Az =0 .770 ) ,两者有统计学显著性差异 (P〈0 .0 5 )。结论 :数字化胸片对于发现与正常解剖结构重叠的肺内单发结节病灶优于传统胸片。

X-ray diagnosis of hidden solitary pulmonary nodules: ROC assessment between conventional and digital radiographs

Objective: To compare digital radiographs displayed on the workstation with conventional radiographs for the detection of solitary pulmonary nodules. Methods: Sixty pairs of chest radiographs, 30 patients with solitary pulmonary nodules confirmed by surgery pathology and 30 normal cases confirmed by serial chest computed tomography (CT), were obtained from both screen-film and digital radiographic system. Four chest radiologists and four residents observed set A (conventional imaging) and set B (digital radiograph) for solitary nodules. Assessment was performed with receiver operating characteristic (ROC) analysis. Results:For the experienced radiologists, observer performance in set A (Az=0.837) was superior to that in set B (Az=0.823) ( P <0.05). For the residents, observer performance in set A (Az=0.842) was superior to that in set B (Az=0.717) ( P <0.05). For all of them, observer performance in set A (Az=0.840) was superior to that in set B (Az=0.770) ( P <0.05). Conclusions: For the detection of solitary pulmonary nodules, digital radiographs is superior to conventional radiographs.