| 王秋萍,张蕴,牛刚,强永乾,闫锐,李自成,郭佑民.孤立性肺肿块CT诊断个体间差异研究[J].中国医学影像技术,2008,24(9):1417~1420 |
| 孤立性肺肿块CT诊断个体间差异研究 |
| Inter-observer variation in CT diagnosis of solitary pulmonary mass |
| 投稿时间：2008-03-27 修订日期：2008-06-30 |
| DOI： |
| 中文关键词: 孤立性肺肿块 体层摄影术,X线计算机 Kappa值 |
| 英文关键词:Solitary pulmonary mass Tomography, X-ray computed Kappa value |
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| 中文摘要: |
| 目的 观察孤立性肺肿块CT诊断在不同观察者之间的吻合度。 方法 三个不同工作经历的临床影像科诊断医师作为观察者,采用双盲法,对经病理证实的49例孤立性肺肿块的CT图片进行评价,评价指标包括肺肿块的边缘、轮廓、分叶、棘状突起、毛刺、密度、空泡征、支气管充气征、空洞、钙化、血管集束征、胸膜凹陷征及病变的良恶性共13项观察指标。观察者一致性用Kappa值(K值)判定。 结果 病灶的良恶性判定在任何两位观察者之间存在适中~较高的一致性(其中观察者1与观察者2对肿块的定性诊断结果一致率为79.59％(39/49,K=0.435,P=0.001);观察者2与观察者3的定性诊断结果一致率为85.71%(42/49,K=0.644,P=0.000);观察者1与观察者3的定性诊断结果一致率为81.63%(40/49,K=0.422,P=0.002)。其余12项CT征象中,肿块的轮廓识别一致性中等;棘状突起、毛刺、密度、支气管充气征、周围血管集束征识别一致性差;轮廓、分叶、空泡征、空洞、钙化、胸膜凹陷征的识别一致性在个体之间不同。 结论 不同资历的影像科医师对于孤立性肺结节征象的识别率存在差异。 |
| 英文摘要: |
| Objective To assess inter-observer variation in CT evaluation of solitary pulmonary mass. Methods Forty-nine cases with pathologically proved solitary pulmonary masses were independently observed by three radiologists with different working experiences on CT image. Evaluation index included demarcation, boundary contour, lobulation, spiculate protuberance, sentus sign, density, vacuole sign, air-bronchogram, cavitas, calcification, vessel convergence, pleural indentation sign and the nature of masses (malignant or benign). The results were analyzed with Kappa test (K value). Results The consistency of recognization of masses’ nature was moderate between every two observers [observer 1 vs 2, consistency rate 79.59％ (39/49, K=0.435, P=0.001), observer 2 vs 3, consistency rate, 85.71% (42/49, K=0.644, P=0.000), observer 1 vs 3, consistency rate 81.63% (40/49, K=0.422, P=0.002). Inter-observer consistency for the presence of boundary contour was moderate, so as inter-observer agreement for the presence of boundary contour, whereas inter-observer consistency for the presence of spiculate protuberance, sentus sign, density, air-bronchogram, and vessel convergence was low, and for the presence of the other CT signs were different. Conclusion There are differences for evaluation of CT signs of solitary pulmonary masses in three radiologists of different working experiences. |
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