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目的 评价不同显示矩阵的影像诊断工作站对识读肺部小结节的影响。方法 选取76张计算机摄影 (CR)胸片 ,其中 36张含有CT证实的直径 <2cm的小结节 ,分为 1 0～ 2 0cm及<1 0cm 2组。 3位诊断医师分别在 1K、2K显示器和数字会诊系统的投影屏幕上识读胸片影像 ,用5分法 :肯定有、可能有、不确定、可能没有、肯定没有 ,独立判断结节存在与否。绘制受试者操作特性(ROC)曲线 ,计算每位医师分别在 1K和 2K的影像诊断工作站及数字会诊系统上识读直径 1 0～2 0cm及 <1 0cm 2组肺部小结节的ROC曲线下的面积 (AZ 值 )及标准误 [s x(AZ) ],并进行比较。结果 3位诊断医师在数字会诊系统、1K及 2K显示器下检测肺部小结节的平均ROC的AZ 值分别为 :直径 1 0～ 2 0cm组 :0 7936、0 82 2 5、0 836 7;<1 0cm组 :0 6 6 98、0 6 998、0 72 32。随着显示器分辨率的提高 ,AZ 值随之提高 ,但是经ROC分析 ,不同观片系统的检测效能差异无显著性意义 (P>0 5 )。结论 用 1K显示器、数字影像会诊系统加用影像后处理 ,特别是放大功能 ,识读肺部直径≥ 1 0cm的小结节是可以的 ,识读肺部 <1 0cm的小结节宜采用 2K× 2K高分辨率工作站。不同显示矩阵的观片系统的合理配置 ,可获得较好的性价比及保证诊断准确性。
Objective To evaluate the effect of imaging diagnostic workstations with different display matrices on the interpretation of small pulmonary nodules. Methods Sixty-six computerized chest radiographs were selected. Thirty-six small nodules with CT diameter <2 cm were divided into 10 ~ 20 cm and <1 0 cm 2 groups. The 3 diagnosticians read the chest radiograph on the projection screens of 1K, 2K displays and digital consultation systems, respectively, using the 5-point method: yes, yes, no, maybe not, definitely not, judging nodules independently no. The receiver operating characteristic (ROC) curve was plotted. Each physician calculated the ROC of small pulmonary nodules of 10 ~ 20 cm in diameter and <1 0 cm 2 at 1K and 2K imaging diagnostic workstations and digital consultation system respectively Area under the curve (AZ value) and standard error [sx (AZ)], and compared. Results The mean ROC values of three small pulmonary nodules detected by three diagnosticians in the digital consultation system, 1K and 2K monitors were: diameter 10 ~ 20cm group 0 7936,0 82 2 5,0 836 7; <1 0 cm group: 0 6 6 98,0 6 998,0 72 32. With the increase of the resolution of the display, the AZ value increased. However, the ROC analysis showed no significant difference in the detection efficiency between different viewing systems (P> 0.05). Conclusion 1K display, digital imaging consultation system plus image post-processing, especially magnification, to read the lung nodules ≥ 10cm diameter is OK, to read the lung <10cm nodules should use 2K × 2K high-resolution workstation. Different display matrix observation system reasonable configuration, get better cost performance and ensure diagnostic accuracy.