Wormanns Dag, Ludwig Karl, Beyer Florian, Heindel Walter, Diederich Stefan
Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany.
Eur Radiol. 2005 Jan;15(1):14-22. doi: 10.1007/s00330-004-2527-6. Epub 2004 Nov 4.
The purpose of this study was to assess the effectiveness of double reading to increase the sensitivity of lung nodule detection at standard-dose (SDCT) and low-dose multirow-detector CT (LDCT). SDCT (100 mAs effective tube current) and LDCT (20 mAs) of nine patients with pulmonary metastases were obtained within 5 min using four-row detector CT. Softcopy images reconstructed with 5-mm slice thickness were read by three radiologists independently. Images with 1.25-mm slice thickness served as the gold standard. Sensitivity was assessed for single readers and combinations. The effectiveness of double reading was expressed as the increase of sensitivity. Average sensitivity for detection of 390 nodules (size 3.9+/-3.2 mm) for single readers was 0.63 (SDCT) and 0.64 (LDCT). Double reading significantly increased sensitivity to 0.74 and 0.79, respectively. No significant difference between sensitivity at SDCT and LDCT was observed. The percentage of nodules detected by all three readers concordantly was 52% for SDCT and 47% for LDCT. Although double reading increased the detection rate of pulmonary nodules from 63% to 74-79%, a considerable proportion of nodules remained undetected. No difference between sensitivities at LDCT and SDCT for detection of small nodules was observed.
本研究的目的是评估双人阅片对提高标准剂量（SDCT）和低剂量多排探测器CT（LDCT）肺结节检测敏感性的效果。使用四排探测器CT在5分钟内获取9例肺转移患者的SDCT（有效管电流100 mAs）和LDCT（20 mAs）图像。由三位放射科医生独立阅读层厚5 mm重建的软拷贝图像。层厚1.25 mm的图像作为金标准。评估单人阅片及组合阅片的敏感性。双人阅片的效果以敏感性增加来表示。单人阅片检测390个结节（大小3.9±3.2 mm）的平均敏感性，SDCT为0.63，LDCT为0.64。双人阅片分别显著提高敏感性至0.74和0.79。未观察到SDCT和LDCT敏感性之间的显著差异。三位阅片者均一致检测到的结节百分比，SDCT为52%，LDCT为47%。虽然双人阅片将肺结节的检测率从63%提高到74% - 79%，但仍有相当比例的结节未被检测到。未观察到LDCT和SDCT检测小结节敏感性之间的差异。
