Uozumi T, Nakamura K, Watanabe H, Nakata H, Katsuragawa S, Doi K
Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu-shi, Japan.
Acad Radiol. 2001 Sep;8(9):871-8. doi: 10.1016/s1076-6332(03)80766-3.
The authors' purpose was to evaluate the effect of temporal subtraction on digital chest radiographs in the detection of metastatic pulmonary nodules.
The study included 21 cases with metastatic pulmonary nodule and 21 cases without metastatic nodule. Eleven radiologists, including eight residents and three certified radiologists, provided their confidence levels for the presence or absence of pulmonary nodules without and with temporal subtraction. Their performances without and with temporal subtraction were evaluated by means of receiver operating characteristic analysis with both independent and sequential tests.
For the independent test, the radiologists' Az (area under the receiver operating characteristic curve) values were 0.871 without and 0.954 with temporal subtraction, compared with 0.882 and 0.955, respectively, for the sequential test. Diagnosis accuracy was significantly improved with the use of temporal subtraction. There was no significant difference in Az values between the independent and sequential tests.
Temporal subtraction is useful in the detection of metastatic pulmonary nodules, and this technique augments the value of digital chest radiography.
作者的目的是评估时间减影对数字化胸部X线片检测肺转移瘤结节的效果。
本研究纳入21例有肺转移瘤结节的病例和21例无转移瘤结节的病例。11名放射科医生，包括8名住院医师和3名认证放射科医生，分别给出了有无时间减影情况下对肺结节存在与否的置信度。通过独立测试和序贯测试的受试者操作特征分析来评估他们在有无时间减影情况下的表现。
对于独立测试，放射科医生的Az（受试者操作特征曲线下面积）值在无时间减影时为0.871，有时间减影时为0.954；对于序贯测试，相应值分别为0.882和0.955。使用时间减影后诊断准确性显著提高。独立测试和序贯测试的Az值之间无显著差异。
时间减影在检测肺转移瘤结节方面有用，且该技术增加了数字化胸部X线摄影的价值。
