發(fā)布時間：2018-04-04 06:29

  本文選題：硬幣病變　切入點：肺　出處：《第二軍醫(yī)大學》2017年碩士論文

【摘要】：肋骨抑制成像在胸部平片實性肺結節(jié)檢測中的應用【目的】評價肋骨抑制成像技術在胸部平片檢出肺結節(jié)中的價值�！痉椒ā炕仡櫺苑治�141例胸部后前位X線片,其中95例有單發(fā)肺結節(jié),作為研究組,46例無肺結節(jié)作為對照組。2名高年資與2名低年資放射科醫(yī)師分別獨立閱讀所有胸部后前位X線片和經肋骨抑制成像技術處理后的胸部后前位X線片。閱讀、記錄結節(jié)的部位、大小并對結節(jié)存在的肯定度進行評分。觀察的結果采用受試者操作特征(ROC)曲線進行分析。【結果】肺結節(jié)的平均直徑為1.9±1cm,直徑范圍是0.9~2.9cm。胸部后前位X線片ROC曲線下面積為0.844,肋骨抑制成像技術處理后的胸部后前位X線片ROC曲線下面積為0.873,兩者有統(tǒng)計學差異(P0.01)�！窘Y論】肋骨抑制成像技術可以顯著提高放射科醫(yī)師對胸部正位X片中肺結節(jié)的檢出率,增加判斷準確率。肋骨抑制成像技術在胸片檢測不同密度、大小及位置肺結節(jié)中的應用【目的】評價肋骨抑制成像技術在胸部平片檢測不同密度、大小和分布位置的肺結節(jié)中應用價值的不同。【資料與方法】回顧性分析128例經CT證實存在肺單發(fā)結節(jié)的胸部后前位X線片和130例正常胸片。將肺結節(jié)根據(jù)密度(實性,混雜磨玻璃,純磨玻璃)、大小(3≤D10mm,10≤D20mm,20≤D30mm)及分布(肺周邊區(qū),肺門區(qū),肺尖區(qū))分組,分別進行分析。2名高年資與2名低年資放射科醫(yī)師分別獨立閱讀所有胸部后前位X線片和經肋骨抑制成像技術處理后的胸部后前位X線片。閱讀、記錄結節(jié)的部位、大小并對結節(jié)存在的肯定度進行評分。觀察的結果采用受試者操作特征(ROC)曲線進行分析。【結果】4名放射科醫(yī)師使用去肋骨圖像前后的平均ROC曲線下面積由0.722提高到0.764,兩者有統(tǒng)計學差異(t=-13.282,P0.01),肺結節(jié)檢出率由51.6%(66/128)提高到58.2%(74.5/128),且對分布在肺周邊區(qū)的實性或者亞實性中等大小(10≤D20mm)的結節(jié)效果最好。【結論】肋骨抑制成像技術可以顯著提高放射科醫(yī)師對胸部后前位X片中肺結節(jié)的檢出率,其效能與結節(jié)的密度、大小和分布有關。CT時間減影技術在肺結節(jié)檢測中的應用【目的】探討多層螺旋CT時間減影技術在檢測肺結節(jié)中的應用價值�！痉椒ā炕仡櫺苑治�80例CT圖像(每例均有過去和當前的CT圖像)和相應的CT減影圖像,其中30例有肺結節(jié)(共75個結節(jié))作為研究組,50例無肺結節(jié)作為對照組。2名高年資與2名低年資放射科醫(yī)師分別首先分析普通CT圖像,然后再同時分析普通圖像與CT減影圖像。閱讀時診斷是否存在較前次增大、實性成分增多或者新發(fā)的結節(jié)并對診斷的肯定度進行評分。觀察的結果采用受試者操作特征(receiver operating characteristics)曲線進行分析�！窘Y果】4名放射科醫(yī)師使用CT減影圖像前后的平均ROC曲線下面積分別為0.860和0.925,兩者有統(tǒng)計學差異(P0.01)。使用CT減影圖像后,肺結節(jié)檢出率由77.3%(58/75)提高到89.3%(67/75)。【結論】CT減影技術可以顯著提高放射科醫(yī)師的肺結節(jié)檢出率,尤其是對靠近肺門的亞實性小結節(jié),而且低年資醫(yī)師受益更多。
[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.

【學位授予單位】：第二軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563;R816.41

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