胸片肋骨抑制成像及CT时间减影技术在肺结节检测中的应用研究

发布时间：2018-04-04 06:29

本文选题：硬币病变　切入点：肺　出处：《第二军医大学》2017年硕士论文

【摘要】：肋骨抑制成像在胸部平片实性肺结节检测中的应用【目的】评价肋骨抑制成像技术在胸部平片检出肺结节中的价值。【方法】回顾性分析141例胸部后前位X线片,其中95例有单发肺结节,作为研究组,46例无肺结节作为对照组。2名高年资与2名低年资放射科医师分别独立阅读所有胸部后前位X线片和经肋骨抑制成像技术处理后的胸部后前位X线片。阅读、记录结节的部位、大小并对结节存在的肯定度进行评分。观察的结果采用受试者操作特征(ROC)曲线进行分析。【结果】肺结节的平均直径为1.9±1cm,直径范围是0.9~2.9cm。胸部后前位X线片ROC曲线下面积为0.844,肋骨抑制成像技术处理后的胸部后前位X线片ROC曲线下面积为0.873,两者有统计学差异(P0.01)。【结论】肋骨抑制成像技术可以显著提高放射科医师对胸部正位X片中肺结节的检出率,增加判断准确率。肋骨抑制成像技术在胸片检测不同密度、大小及位置肺结节中的应用【目的】评价肋骨抑制成像技术在胸部平片检测不同密度、大小和分布位置的肺结节中应用价值的不同。【资料与方法】回顾性分析128例经CT证实存在肺单发结节的胸部后前位X线片和130例正常胸片。将肺结节根据密度(实性,混杂磨玻璃,纯磨玻璃)、大小(3≤D10mm,10≤D20mm,20≤D30mm)及分布(肺周边区,肺门区,肺尖区)分组,分别进行分析。2名高年资与2名低年资放射科医师分别独立阅读所有胸部后前位X线片和经肋骨抑制成像技术处理后的胸部后前位X线片。阅读、记录结节的部位、大小并对结节存在的肯定度进行评分。观察的结果采用受试者操作特征(ROC)曲线进行分析。【结果】4名放射科医师使用去肋骨图像前后的平均ROC曲线下面积由0.722提高到0.764,两者有统计学差异(t=-13.282,P0.01),肺结节检出率由51.6%(66/128)提高到58.2%(74.5/128),且对分布在肺周边区的实性或者亚实性中等大小(10≤D20mm)的结节效果最好。【结论】肋骨抑制成像技术可以显著提高放射科医师对胸部后前位X片中肺结节的检出率,其效能与结节的密度、大小和分布有关。CT时间减影技术在肺结节检测中的应用【目的】探讨多层螺旋CT时间减影技术在检测肺结节中的应用价值。【方法】回顾性分析80例CT图像(每例均有过去和当前的CT图像)和相应的CT减影图像,其中30例有肺结节(共75个结节)作为研究组,50例无肺结节作为对照组。2名高年资与2名低年资放射科医师分别首先分析普通CT图像,然后再同时分析普通图像与CT减影图像。阅读时诊断是否存在较前次增大、实性成分增多或者新发的结节并对诊断的肯定度进行评分。观察的结果采用受试者操作特征(receiver operating characteristics)曲线进行分析。【结果】4名放射科医师使用CT减影图像前后的平均ROC曲线下面积分别为0.860和0.925,两者有统计学差异(P0.01)。使用CT减影图像后,肺结节检出率由77.3%(58/75)提高到89.3%(67/75)。【结论】CT减影技术可以显著提高放射科医师的肺结节检出率,尤其是对靠近肺门的亚实性小结节,而且低年资医师受益更多。
[Abstract]:Application [rib suppression imaging in chest radiography solid pulmonary nodules detection in rib suppression imaging evaluation objective] detection of pulmonary nodules in chest X-ray. [Methods] a retrospective analysis of 141 cases of chest posteroanterior radiograph, and 95 cases of solitary pulmonary nodules, 46 cases as the study group. Pulmonary nodules as control group.2 senior and 2 junior radiologists independently read all chest radiographs before and after treatment by inhibiting imaging of the chest rib after radiographs. Reading, recorded the location and size of nodules, wasassessed certainly exist. The results of observation nodules by receiver operating characteristic (ROC) curve analysis. [results] the average diameter of pulmonary nodules was 1.9 + 1cm, the diameter range is 0.9~2.9cm. area before and after chest radiographs of ROC curve was 0.844 and the rib suppression after chest imaging The area after the first radiograph under the ROC curve was 0.873, both statistically different (P0.01). [Conclusion] rib suppression imaging technology can significantly improve the detection rate of lung nodules on chest radiologists are X of the increase of accuracy. The measurement of different density of rib suppression imaging technique in chest X-ray examination, and Application [size the location of pulmonary nodules Objective] evaluation rib imaging technology in the inhibition of chest X-ray detection of different density, the application value of pulmonary nodule size and distribution in different locations. [materials and methods] a retrospective analysis of 128 cases of CT confirmed the presence of pulmonary nodules before and after single chest radiographs and 130 normal cases. The pulmonary nodules based on density (solid, mixed ground glass, pure ground glass), size (3 D10mm, 10 D20mm, 20 D30mm) and distribution (peripheral lung area, lung area, lung area) group, were analyzed.2 senior and 2 year low The radiologist independently read all information before chest radiographs and chest imaging by inhibition of rib after X-ray film. Before reading, recorded the location and size of nodules, wasassessed certainly exist. The results of observation nodules using receiver operating characteristic (ROC) curve analysis. [results 4 radiologists] used to mean ROC images before and after the area under the curve of ribs increased from 0.722 to 0.764, both statistically different (t=-13.282, P0.01), pulmonary nodules detection rate is 51.6% (66/128) to 58.2% (74.5/128), and the distribution in lung peripheral area solid or solid medium size (sub 10 = D20mm) the best nodule effect. [Conclusion] rib suppression imaging technology can significantly improve the pulmonary nodules on chest radiologists after anterior X in the detection rate, the efficiency and the density of the nodule size and distribution,.CT The application value of application technology in the detection of pulmonary nodules shadow [Objective] to investigate the multi-slice spiral CT time subtraction technique in the detection of lung nodules in time reduced. [Methods] a retrospective analysis of 80 cases of CT images (each case had past and current CT images) and the corresponding CT subtraction images in 30 cases pulmonary nodules (75 nodules) as the study group, 50 patients without pulmonary nodules as control group.2 senior and 2 junior radiologists respectively analyzed the common CT image, and then the analysis of common image and CT subtraction image. When reading the diagnosis of the existence of previous increases, the solid component increased or new hair and nodules for diagnosis of certain scores. To observe the results of using receiver operating characteristic (receiver operating characteristics) curve were analyzed. [results] 4 radiologists using CT minus the average curve of ROC images before and after Under the area were 0.860 and 0.925, both have significant difference (P0.01). Using CT subtraction images, pulmonary nodules detection rate is 77.3% (58/75) to 89.3% (67/75). [Conclusion] CT subtraction technique can significantly improve the detection rate of pulmonary nodules by, especially for sub nodules near the hilum of lung, and junior doctors benefit more.

【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563;R816.41

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