亚实性肺结节CT三维质量分析:观察者内及观察者间差异

发布时间：2018-04-24 10:36

本文选题：亚实性结节 + 质量测量　；参考：《中国肺癌杂志》2015年05期

【摘要】：背景与目的肺内亚实性结节(包括磨玻璃密度结节和部分实性结节)体积增长常较缓慢,但恶性概率比实性结节大,常需随访确定其生长特性。恶性亚实性结节的生长性不仅可以表现为体积的增长,也可以表现为密度的增加或新出现实性成分。计算机断层扫描(computed tomography,CT)质量(Mass)测量能综合评估其体积及密度的变化,在结节随访中量化反映其生长特性。本研究目的是评估亚实性结节质量测量的重复性,并与体积测量重复性比较。方法两名医生盲法应用结节分析软件对44例患者共80个亚实性结节的CT影像资料进行三维体积及质量重复测量,对自动分割效果不佳的结节采用手动调整。应用Bland-Altman法评估质量测量及体积测量的观察者内及观察者间差异,组内相关及Wilcoxon检验评估质量测量与体积测量观察者内、间测量变异度的差异。结果74个(92.5%)亚实性结节分割效果满意纳入研究。结节直径(7.2±2.5)mm(3.2 mm-16.4 mm)。质量测量的观察者内、观察者间95%一致性区间分别为-11.5%-10.4%、-17.4%-19.3%,体积测量的观察者内、观察者间95%一致性区间分别为-8.4%-8.8%、-17.9%-19.4%,观察者内、间质量测量与体积测量变异度的组内相关系数分别为0.95、0.93(P均0.001),二者之间无统计学差异(P值分别为0.78、0.09)。手动调整结节分割对测量的重复性有一定影响。结论亚实性肺结节的质量测量重复性较好,可作为随访定量评估方法。
[Abstract]:Background and objective the volume growth of subsolid pulmonary nodules (including ground glass density nodules and partial solid nodules) is usually slower, but the probability of malignancy is larger than that of solid nodules. The growth of malignant subsolid nodules can be characterized not only by the increase of volume but also by the increase of density or the emergence of new realistic components. Mass mass mass (Mass) measurements of computed tomography can comprehensively evaluate the changes in volume and density of computed tomography, and quantitatively reflect their growth characteristics during the follow-up of nodules. The aim of this study was to evaluate the reproducibility of mass measurement of subsolid nodules and to compare it with volume measurement. Methods the CT images of 80 subreal nodules of 44 patients were measured by two doctors' blind nodule analysis software. The volume and quality of 80 subreal nodules were measured repeatedly. Manual adjustment was used for the nodules with poor automatic segmentation. Bland-Altman method was used to evaluate the intra-observer and inter-observer differences in mass and volume measurements, and the intra-group correlation and Wilcoxon test were used to evaluate the variability between the quality measurement and volume measurement. Results Seventy-four subsolid nodules were included in the study. The diameter of nodules was 7. 2 卤2.5)mm(3.2 mm-16.4. Within the observers of mass measurement, the 95% consistency interval between observers was -11.5-10.4 and 17.4- 19.3. within the observers of volume measurement, the 95% consistency interval between observers was -8.4-8.8and -17.9- 19.4respectively. The intra-group correlation coefficients of the variation of mass measurement and volume measurement were 0.95 ~ 0.93 (P = 0.001) and there was no significant difference between the two groups (P = 0.78 卤0.09). Manual adjustment of nodule segmentation has a certain effect on the repeatability of measurement. Conclusion the quality measurement of subsolid pulmonary nodules is reproducible and can be used as a quantitative evaluation method for follow-up.
【作者单位】：天津医科大学总医院放射科;
【基金】：国家自然科学基金面上项目(No.81171345) 中央补助地方公共卫生专项资金肺癌早诊早治项目 2012年高等学校博士学科点专项科研基金(No.20121202110005)资助~~
【分类号】：R734.2;R730.44

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