孤立性肺肿块CT诊断能力的统计评价

王秋萍; 牛刚; 张蕴; 强永乾; 闫锐; 李自成; 郭佑民

中国临床医学影像杂志 ›› 2008, Vol. 19 ›› Issue (10) : 726-729.

论著

孤立性肺肿块CT诊断能力的统计评价

王秋萍¹，牛刚¹，张蕴¹，强永乾¹，闫锐²，李自成³，郭佑民⁴

作者信息 +

The statistical evaluation of CT diagnosis for solitary pulmonary mass

WANG Qiu-ping¹, NIU Gang¹, ZHANG Yun¹, QIANG Yong-qian¹, YAN Rui², LI Zi-cheng³, GUO You-min⁴

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文章历史 +

摘要

目的：通过分析不同工作经历医师的CT诊断差异，探讨提高孤立性肺肿块CT诊断的方法及途径。方法：3位不同工作经历医师用双盲法对孤立性肺肿块CT图像进行定性诊断，与病理结果对照，分别计算其CT诊断的敏感度、特异度、准确度、阳性预测值、阴性预测值、Youden指数及与病理诊断之间的Kappa值、ROC曲线下面积。根据其诊断结果，进行诊断试验的统计评价。结果：3位医师对同一组孤立性肺肿块CT图像进行6次判断，其总敏感度为83.76％（196/234），特异度为53.33％（32/60），准确度为77.55％（228/294），阳性预测值87.50％（196/224），阴性预测值45.71％（32/70），Youden指数为0.371，与病理结果比较的Kappa值为0.349（标准误：0.64，P＝0.000）。ROC曲线下面积比较无统计学差异。观察者之间CT诊断结果稳定性存在统计学差异。结论：CT在一定程度上能够反映肺结节的良恶性病理学特点。随访和专题培训是提高影像医师诊断水平的良好方法。

Abstract

To Compare the difference of CT diagnostic results for solitary pulmonary mass among different qualification physicians, through analysis there are different CT diagnostic accuracy among observers with different working background and experience. To explore methods and ways for raising CT diagnostic level of solitary pulmonary tumor is important. Methods: Forty-nine cases with pathologically proved solitary pulmonary mass are independently diagnosed with double blind method by three radiologists of different work experience on CT image. This study is to evaluate the sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value and Youden value of solitary pulmonary mass. Result: There were six evaluation results for the same group of solitary pulmonary mass from three physicians. The sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value and Youden value was 83.76％（196/234）, 53.33％（32/60）, 77.55％（228/294）, 87.50％（196/224）, 45.71％（32/70）, 0.371 respectively. The Kappa value was 0.349（standard error: 0.64, P＝0.000） for pathological diagnosis. There were no statistical significance of ROC area under the curve. The CT diagnostic results of stability between each radiologist exists statistical significance. Conclusion: To a certain extent, CT imaging could show the benign and malignant pathological features of solitary pulmonary mass. Follow-up visit, and special training are good methods for improving the diagnostic level of solitary pulmonary mass.

导出引用

王秋萍;牛刚;张蕴;强永乾;闫锐;李自成;郭佑民. 孤立性肺肿块CT诊断能力的统计评价[J]. 中国临床医学影像杂志. 2008, 19(10): 726-729

WANG Qiu-ping;NIU Gang;ZHANG Yun;QIANG Yong-qian;YAN Rui;LI Zi-cheng;GUO You-min. The statistical evaluation of CT diagnosis for solitary pulmonary mass[J]. Journal of China Clinic Medical Imaging. 2008, 19(10): 726-729

中图分类号： Ｒ734.2 Ｒ563 Ｒ814.42