Baek Hye Jin, Kim Dong Wook, Ryu Ji Hwa, Lee Yoo Jin
Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Iran J Radiol. 2013 Sep;10(3):140-7. doi: 10.5812/iranjradiol.6353. Epub 2013 Aug 30.
There has been no study to compare the diagnostic accuracy of an experienced radiologist with a trainee in nasal bone fracture.
To compare the diagnostic accuracy between conventional radiography and computed tomography (CT) for the identification of nasal bone fractures and to evaluate the interobserver reliability between a staff radiologist and a trainee.
A total of 108 patients who underwent conventional radiography and CT after acute nasal trauma were included in this retrospective study. Two readers, a staff radiologist and a second-year resident, independently assessed the results of the imaging studies.
Of the 108 patients, the presence of a nasal bone fracture was confirmed in 88 (81.5%) patients. The number of non-depressed fractures was higher than the number of depressed fractures. In nine (10.2%) patients, nasal bone fractures were only identified on conventional radiography, including three depressed and six non-depressed fractures. CT was more accurate as compared to conventional radiography for the identification of nasal bone fractures as determined by both readers (P <0.05), all diagnostic indices of an experienced radiologist were similar to or higher than those of a trainee, and κ statistics showed moderate agreement between the two diagnostic tools for both readers. There was no statistical difference in the assessment of interobserver reliability for both imaging modalities in the identification of nasal bone fractures.
For the identification of nasal bone fractures, CT was significantly superior to conventional radiography. Although a staff radiologist showed better values in the identification of nasal bone fracture and differentiation between depressed and non-depressed fractures than a trainee, there was no statistically significant difference in the interpretation of conventional radiography and CT between a radiologist and a trainee.
尚无研究比较经验丰富的放射科医生与实习生对鼻骨骨折的诊断准确性。
比较传统X线摄影和计算机断层扫描（CT）对鼻骨骨折的诊断准确性，并评估放射科医生与实习生之间的观察者间可靠性。
本回顾性研究纳入了108例急性鼻外伤后接受传统X线摄影和CT检查的患者。两名阅片者，一名放射科医生和一名二年级住院医师，独立评估影像学检查结果。
108例患者中，88例（81.5%）确诊为鼻骨骨折。非凹陷性骨折的数量高于凹陷性骨折。9例（10.2%）患者仅在传统X线摄影中发现鼻骨骨折，包括3例凹陷性骨折和6例非凹陷性骨折。两位阅片者均认为，与传统X线摄影相比，CT在鼻骨骨折的诊断上更准确（P<0.05），经验丰富的放射科医生的所有诊断指标均与实习生相似或更高，κ统计显示两种诊断工具对两位阅片者的诊断结果具有中度一致性。在鼻骨骨折的识别中，两种影像学检查方法在观察者间可靠性评估上无统计学差异。
在鼻骨骨折的识别方面，CT明显优于传统X线摄影。虽然放射科医生在鼻骨骨折的识别以及凹陷性骨折与非凹陷性骨折的鉴别上比实习生表现更好，但放射科医生和实习生在传统X线摄影和CT的解读上无统计学显著差异。
