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目的应用Kappa统计量评价不同观察者对中耳胆脂瘤的高分辨率CT(HRCT)诊断的一致性。方法回顾分析150例慢性中耳炎患者共166侧耳的颞骨HRCT图像,所得结果与原始颞骨HRCT报告结果进行Kappa统计分析;进一步以手术中及病理结果为金标准,分别评价颞骨HRCT初诊和再诊对中耳胆脂瘤和听骨链病变的敏感性、特异性和准确性。结果中耳胆脂瘤HRCT初诊和再诊具有很好的诊断一致性,其Kappa值为0.752;HRCT对胆脂瘤破坏听骨链的诊断一致性良好,Kappa值为0.60;颞骨HRCT初诊和再诊对中耳胆脂瘤和听骨链病变的敏感性、特异性和准确性分别是86.9%、93%、91.6%和84.8%、91.7%、89.8%;颞骨HRCT初诊和再诊对听骨链病变的敏感性、特异性和准确性分别为86.6%、90.4%、88.6%和85.4%、81%、83.1%。结论 HRCT初诊和再诊对中耳胆脂瘤的诊断一致性良好,但在显示听骨链的完整形态方面一致性稍差。
Objective To assess the consistency of high-resolution CT (HRCT) diagnosis of middle ear cholesteatoma using different Kappa statistics. Methods A total of 166 patients with chronic otitis media were retrospectively analyzed of temporal bone HRCT images. The results were compared with those of the original temporal bone HRCT report by Kappa statistical analysis. The intraoperative and pathological results were used as the gold standard to evaluate the newly diagnosed, Ear cholesteatoma and ossicular chain disease sensitivity, specificity and accuracy. Results The diagnosis and diagnosis of middle ear cholesteatoma HRCT had good diagnostic consistency and the Kappa value was 0.752. HRCT was consistent with the diagnosis of cholesteatoma destruction of ossicular chain, Kappa value was 0.60; The sensitivity, specificity and accuracy of the diagnosis of middle ear cholesteatoma and ossicular chain disease were 86.9%, 93%, 91.6% and 84.8%, 91.7% and 89.8% respectively. The sensitivity, specificity and accuracy of the chain lesions were 86.6%, 90.4%, 88.6% and 85.4%, 81% and 83.1%, respectively. Conclusions The diagnosis of middle ear cholesteatoma is well consistent in the newly diagnosed and re-diagnosed HRCT, but it is less consistent in showing the complete morphology of the ossicular chain.