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移动图像解读:平板电脑上显示的CT检查在检测腹盆腔出血方面的诊断性能

Mobile Image Interpretation: Diagnostic Performance of CT Exams Displayed on a Tablet Computer in Detecting Abdominopelvic Hemorrhage.

作者信息

Schlechtweg Philipp M, Kammerer Ferdinand J, Seuss Hannes, Uder Michael, Hammon Matthias

机构信息

Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany.

出版信息

J Digit Imaging. 2016 Apr;29(2):183-8. doi: 10.1007/s10278-015-9829-x.

Abstract

To investigate whether abdominopelvic hemorrhage shown on computed tomography (CT) images can be diagnosed with the same accuracy on a tablet computer as on a dedicated reading display. One hundred patients with a clinical suspicion of abdominopelvic hemorrhage that underwent biphasic CT imaging were retrospectively read by two readers on a dedicated reading display (reference standard) and on a tablet computer (iPad Air). Reading was performed in a dedicated reading room with ambient light conditions. Image evaluation included signs of an active hemorrhage (extravasation of contrast media) and different signs indicating a condition after abdominopelvic hemorrhage (hematoma, intestinal clots, vessel stump, free abdominopelvic fluid with a mean Hounsfield unit value >20, and asymmetric muscle volume indicating intramuscular hemorrhage). Sensitivity, specificity, and positive and negative predictive values (PPV/NPV) were calculated for the tablet-based reading. Active abdominopelvic hemorrhage (n = 72) was diagnosed with the tablet computer with a sensitivity of 0.96, a specificity of 0.93, a PPV of 0.97, and an NPV of 0.90. The results for the detection of the signs indicating a condition after abdominopelvic hemorrhage range from 0.83 to 1.00 in the case of sensitivity, from 0.95 to 1.00 in the case of specificity, from 0.94 to 1.00 in the case of the PPV, and from 0.96 to 1.00 in the case of the NPV. Abdominopelvic hemorrhage shown on CT images can be diagnosed on a tablet computer with a high diagnostic accuracy allowing mobile on-call diagnoses. This may be helpful because an early and reliable diagnosis at any time is crucial for an adequate treatment strategy.

摘要

为了研究计算机断层扫描(CT)图像上显示的腹盆腔出血在平板电脑上的诊断准确性是否与在专用阅片显示器上相同。对100例临床怀疑腹盆腔出血并接受双期CT成像的患者,由两名阅片者分别在专用阅片显示器(参考标准)和平板电脑(iPad Air)上进行回顾性阅片。阅片在有环境光条件的专用阅片室进行。图像评估包括活动性出血的征象(造影剂外渗)以及指示腹盆腔出血后情况的不同征象(血肿、肠内血凝块、血管残端、平均亨氏单位值>20的腹盆腔游离液体以及提示肌肉内出血的不对称肌肉体积)。计算基于平板电脑阅片的敏感性、特异性、阳性和阴性预测值(PPV/NPV)。平板电脑对活动性腹盆腔出血(n = 72)的诊断敏感性为0.96,特异性为0.93,PPV为0.97,NPV为0.90。对于指示腹盆腔出血后情况的征象检测结果,敏感性范围为0.83至1.00,特异性范围为0.95至1.00,PPV范围为0.94至1.00,NPV范围为0.96至1.00。CT图像上显示的腹盆腔出血在平板电脑上能够以较高的诊断准确性进行诊断,从而实现移动出诊诊断。这可能会有所帮助,因为随时进行早期且可靠的诊断对于制定适当的治疗策略至关重要。

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