Kew M C, Osler H I, McCann W G, Esser J, Levin J
S Afr Med J. 1979 Jul 28;56(4):127-9.
Radiocolloid liver scans from 58 patients with primary liver cancer and 56 patients with amoebic liver abscess were examined 'blind' and independently by three nuclear physicians and one registrar in training in order to evaluate the accuracy of the differential diagnosis between the two conditions and to assess the extent of inter-observer variability in the interpretation of these scans. Each of the observers incorrectly interpreted about 12% of scintiphotographs and at least one observer was wrong in 25% of the scans. The difference in diagnostic accuracy between individual observers was not statistically significant. Observers disagreed in 21,6% of the scans. The main reasons for misdiagnosis were failure to realize that excessive extrahepatic uptake of radiocolloid can occur with liver abscesses, and the indistinguishable appearance of the defect or defects in some cases of primary liver cancer and amoebic liver abscess. This margin of error and of inter-observer variability must be borne in mind when interpreting liver scans of patients thought to have either primary liver cancer of amoebic liver abscess.
为了评估两种病症鉴别诊断的准确性以及评估这些扫描图像解读过程中观察者间的差异程度，三位核医学医师和一位正在接受培训的住院医生对58例原发性肝癌患者和56例阿米巴肝脓肿患者的放射性胶体肝扫描图像进行了“盲法”独立检查。每位观察者错误解读了约12%的闪烁照片，并且在25%的扫描图像中至少有一位观察者判断错误。个体观察者之间诊断准确性的差异无统计学意义。观察者在21.6%的扫描图像上存在分歧。误诊的主要原因是未认识到肝脓肿可出现放射性胶体肝外摄取过多，以及在某些原发性肝癌和阿米巴肝脓肿病例中缺损的表现难以区分。在解读疑似原发性肝癌或阿米巴肝脓肿患者的肝脏扫描图像时，必须牢记这一误差范围和观察者间的差异。
