移动计算机射线摄影与移动平板射线摄影在床边胸部摄影中的对比研究：使用防散射栅对选定具有诊断意义的结构的可视性的影响。

Comparative study between mobile computed radiography and mobile flat-panel radiography for bedside chest radiography: impact of an antiscatter grid on the visibility of selected diagnostically relevant structures.

机构信息

From the *Department of Diagnostic and Interventional Radiology, Clinic of Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany; †Department of Radiology, Alexandria University Hospital, Alexandria, Egypt; Departments of ‡Trauma, Hand, and Reconstructive Surgery, and §Biostatistics and Mathematical Modeling, Clinic of Johann Wolfgang Goethe University Frankfurt, Frankfurt; and ∥Department for Radiology and Nuclear Medicine, Catholic Clinic Mainz, Mainz, Germany.

出版信息

Invest Radiol. 2014 Jan;49(1):1-6. doi: 10.1097/RLI.0b013e3182a56654.

DOI:10.1097/RLI.0b013e3182a56654

PMID:24019019

Abstract

OBJECTIVES

The objective of this study was to evaluate the diagnostic performance of 2 different imaging systems in adult bedside chest radiography and the impact on the visibility of selected diagnostically relevant structures in the images acquired with these systems, with and without an antiscatter grid.

MATERIALS AND METHODS

We acquired bedside chest radiographs of 103 intensive-care patients (36 women, 67 men; age range, 17-90 years; mean age, 66.4 years) using 4 acquisition techniques (computed radiography [CR] and digital radiography [DR], with and without grid). Image quality was evaluated independently by 4 radiologists using a 9-point visibility scale. Evaluated were lung parenchyma, soft tissues, thoracic spine, foreign bodies, and the overall image quality. Interobserver agreement and differences between the systems were tested using an interclass correlation (ICC) test. Mean scores were compared using the analysis of variance, followed by the post hoc pairwise testing (the Tukey test) in case of multiple group comparisons and by the Student t test in case of single group comparisons (P < 0.05, significant).

RESULTS

The image quality of the structures evaluated in the DR images with a grid was significantly higher than that obtained without a grid (P < 0.001) for all structures. The use of a grid in CR significantly improved the overall image quality, lung parenchyma, and soft tissue delineation (P < 0.001). Foreign body delineation, however, was significantly better in the CR images obtained without a grid (P < 0.001), whereas the 2 systems showed no significant difference regarding thoracic spine delineation (P = 0.554). The scores of the DR images were significantly higher than those of the CR images for all structures. The interobserver agreement was substantial for lung parenchyma (ICC, 0.77), soft tissue (ICC, 0.78), thoracic spine (ICC, 0.80), and the overall image quality (ICC, 0.78) and was almost perfect for foreign bodies (ICC, 0.81).

CONCLUSIONS

The use of an antiscatter grid significantly improved the image quality of bedside DR radiographs. A similar effect was seen with CR radiographs but only for lung parenchyma, soft tissue, and the overall image quality. Mobile DR outperformed CR in all structures.

摘要

目的

本研究旨在评估两种不同成像系统在成人床边胸部放射摄影中的诊断性能，以及这些系统在使用和不使用散射格栅时获取的图像中对选定诊断相关结构的可见度的影响。

材料与方法

我们对 103 例重症监护患者（36 名女性，67 名男性；年龄范围 17-90 岁；平均年龄 66.4 岁）进行了床边胸部放射摄影，使用了 4 种采集技术（计算机放射摄影 [CR]和数字放射摄影 [DR]，有和没有格栅）。4 名放射科医生使用 9 分可视性量表独立评估图像质量。评估的内容包括肺实质、软组织、胸椎、异物和整体图像质量。使用组内相关系数（ICC）检验测试观察者间的一致性和系统间的差异。使用方差分析比较平均得分，然后在多组比较时使用事后两两比较（Tukey 检验），在单组比较时使用学生 t 检验（P<0.05，差异显著）。

结果

DR 图像中使用格栅的结构的图像质量明显高于无格栅的图像（所有结构，P<0.001）。CR 中使用格栅可显著改善整体图像质量、肺实质和软组织描绘（P<0.001）。然而，异物的描绘在无格栅的 CR 图像中明显更好（P<0.001），而 2 种系统在胸椎的描绘方面没有显著差异（P=0.554）。所有结构的 DR 图像的得分均明显高于 CR 图像。肺实质（ICC，0.77）、软组织（ICC，0.78）、胸椎（ICC，0.80）和整体图像质量（ICC，0.78）的观察者间一致性较高，异物（ICC，0.81）的观察者间一致性几乎为完美。