胸部低剂量CT与DR对肺部病变检出对比研究

目的 对比胸部低剂量CT与胸部数字化X线摄影(DR)对肺部病灶的检出差别.方法 回顾性分析重庆医科大学附属第一医院放射科216例48 h内先后行胸部低剂量CT及DR检查图像,由2位高年资医师双盲阅片,并对二者阅片结果进行肺内病变总体检出κ一致性检验;取一致性系数较高者数据,按肿块(直径>3.0 cm)、大结节(直径0....

Comparative study of pulmonary lesions detected by low-dose chest CT and DR

Objective To compare the difference in the detection of lung lesions between low-dose chest CT and digital radiography(DR).Methods The images of 216 patients who received low-dose CT and DR examination within 48 h in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.The datas were double-blind read by two senior physicians,and double-blind random reliability analysis was conducted.The κ consistency test was performed for the overall detection of pulmonary lesions.The data of the patients with higher consistency coefficient were selected and classified according to mass(diameter>3.0 cm),macronodules(diameter 0.5-3.0 cm),small nodules(diameter<0.5 cm),exussed consolidation,fibrosis and calcification,bulla and emphysema of lung,thoracic and pleural lesions.The pathologicalκconsistency test was performed for each classification.Using CT as the detection standard,the rate of missed detection,misdetection rate and accuracy of DR radiographs were evaluated,and the main reasons were analyzed.Results Intra-group correlation coefficient(ICC)for reproducibility evaluation of chest CT double-blind radiograph reading was 0.863,and chest DR double-blind radiograph reading ICC was 0.910.The overall consistency coefficient of physician 1(κ=0.555,P<0.001)was higher than that of physician 2(κ=0.448,P<0.001),the chest low-dose CT and DR data of the physician 1 were obtained.Compared with low-dose CT,the rates of missed detection,misdetection and accuracy of DR radiographs were 81.06%,22.81%and 18.94%.The size,density and location of the lesion are the main reasons for missed diagnosis and misdiagnosis of mass,nodules and exudative consolidation lesions.Conclusion Compared with low-dose chest CT,DR radiography has a higher rate of missed detection and a lower rate of false detection and accuracy.Low-dose chest CT is better than DR in the detection of pathological changes.