乞文旭,潘诗农,郭启勇,郭文力,陆晓梅.256层螺旋CT诊断肋软骨骨折:窗宽、窗位优化分析[J].中国医学影像技术,2010,26(2):355~357
256层螺旋CT诊断肋软骨骨折:窗宽、窗位优化分析
Optimal window width and center level settings in 256-slice spiral CT diagnosis of costal cartilage fracture
投稿时间:2009-09-23  修订日期:2009-11-05
DOI:
中文关键词:  体层摄影术,X线计算机  肋软骨  骨折  窗宽  窗位
英文关键词:Tomography, X-ray computed  Costal cartilage  Fracture  Window width  Window level
基金项目:
作者单位E-mail
乞文旭 中国医科大学附属盛京医院放射科,辽宁 沈阳 110004  
潘诗农 中国医科大学附属盛京医院放射科,辽宁 沈阳 110004 pansn@sj-hosptial.org 
郭启勇 中国医科大学附属盛京医院放射科,辽宁 沈阳 110004  
郭文力 中国医科大学附属盛京医院放射科,辽宁 沈阳 110004  
陆晓梅 中国医科大学附属盛京医院放射科,辽宁 沈阳 110004  
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中文摘要:
      目的 应用ROC曲线分析法探讨256层螺旋CT诊断肋软骨骨折的最佳窗宽、窗位。方法 对30例患者行胸部256层螺旋CT扫描。由3位影像医师分别测量所有病例肋软骨CT值,并采用"双盲法"在PACS网上软拷贝阅读每例患者甲(1120 HU窗宽,-100 HU窗位)、乙(1120 HU窗宽,100 HU窗位)、丙(1120 HU窗宽,300 HU窗位)3种窗宽、窗位的图像,并在①肯定正常,②可疑正常,③不能肯定,④可疑骨折,⑤肯定骨折中做出选择。采用SPSS 16.0统计软件进行数据处理,对诊断结果进行ROC曲线分析,以ROC曲线下的面积(Az)大小表示3位医师3种窗宽、窗位下的诊断准确率。结果 256层螺旋CT诊断结合临床随访确诊8例共12处肋软骨骨折。30例患者肋软骨的平均CT值为(98.78±32.86)HU。3位医师1120 HU窗宽、100 HU窗位下Az值均大于其他两种窗宽、窗位(P=0.045,P=0.002,P均<0.05),表明该窗宽、窗位的诊断效能更为优越。K检验表明所有诊断结果3位医师组间一致性较高。结论 256层螺旋CT能够有效诊断肋软骨损伤,优化最佳窗宽、窗位有助于影像诊断。
英文摘要:
      Objective To investigate the optimal window level and center level settings in the diagnosis of costal cartilage fracture with 256-slice spiral CT through ROC analysis. Methods Thirty patients with suspected costal cartilage fractures underwent 256-slices chest spirals CT scaning. CT value of costal cartilage was measured by three experienced radiologists. The soft copy images of three kinds of window level and window width (-100 HU/1120 HU, 100 HU/1120 HU, 300 HU/1120 HU) were analyzed independently in PACS with dual-blind method, and the diagnosis results were taken ROC analysis with SPSS 16.0 software. The diagnostic accuracy of three physicians were evaluated and compared according to the area under the ROC curve (Az). Results A total of 8 patients of costal cartilage fractures were confirmed by CT diagnosis combined with clinical follow-up. The mean CT value of 30 patients was (98.78±32.86) HU. The area under the ROC curve with the window level and center level settings of (100 HU/1120 HU) were bigger than that of other window level and window width (P=0.045,P=0.002). Kappa identity test showed that there was a powerful conformability between the diagnostic results of three physicians. Conclusion 256-slice spiral CT is a good way for the diagnosis of costal cartilage fractures with suitable window level and center level settings.
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