Steckel R J, Batra P, Johnson S, Sayre J, Brown K, Haker K, Young D, Zucker M
Department of Radiological Sciences, UCLA School of Medicine 90024-1721, USA.
AJR Am J Roentgenol. 1995 Apr;164(4):837-41. doi: 10.2214/ajr.164.4.7726034.
This study was to determine whether different digital display formats for portable chest radiographs of coronary care unit patients would provide comparable information for clinical care. In particular, we tried to ascertain whether 1024 x 1024 pixel (1K) images on a picture archiving and communication system (PACS) workstation would be comparable to 1760 x 2140 pixel (2K) images on workstations or to digital films. If comparability could be proved, we hypothesized that 1K workstations could considerably lower equipment and film costs and facilitate image transmission from point to point.
Four chest radiologists read a panel of chest studies assembled from 98 coronary care unit patients, comparing 1K and 2K soft-copy images with digital hard copies. For all three image types for the 98 patients, the readers evaluated nine image parameters that the cardiologists deemed essential for clinical decision making. Two other chest radiologists reviewed each patient's three image types, historical chest images, current and prior radiologic reports, and medical record to determine the consensus, or "truth findings."
With one exception (small pleural effusions), the receiver operating characteristic analysis showed no significant differences in the clinical information derived from the three image types.
For clinical management in a coronary care unit, comparable information can be obtained from digital radiologic chest studies using a 1K x 1K soft-copy format, a 2K x 2K soft-copy format, or a hard copy (film). Substantial savings in cost and time are therefore possible by using soft-copy images and lower resolution (1K x 1K) workstations and, when necessary, by transmitting images on regular telephone lines.
本研究旨在确定冠心病监护病房患者便携式胸部X光片的不同数字显示格式是否能为临床护理提供可比信息。具体而言，我们试图确定图片存档与通信系统（PACS）工作站上的1024×1024像素（1K）图像是否与工作站上的1760×2140像素（2K）图像或数字胶片可比。如果能证明其可比性，我们推测1K工作站可大幅降低设备和胶片成本，并便于点对点图像传输。
四位胸部放射科医生阅读了一组从98例冠心病监护病房患者中收集的胸部研究资料，将1K和2K软拷贝图像与数字硬拷贝进行比较。对于这98例患者的所有三种图像类型，阅读者评估了心脏病专家认为对临床决策至关重要的九个图像参数。另外两位胸部放射科医生审查了每位患者的三种图像类型、历史胸部图像、当前和先前的放射学报告以及病历，以确定共识或“真实结果”。
除一个例外（少量胸腔积液），接受者操作特征分析表明，从三种图像类型获得的临床信息无显著差异。
对于冠心病监护病房的临床管理，使用1K×1K软拷贝格式、2K×2K软拷贝格式或硬拷贝（胶片）的数字放射学胸部研究可获得可比信息。因此，通过使用软拷贝图像和较低分辨率（1K×1K）的工作站，并在必要时通过普通电话线传输图像，可大幅节省成本和时间。
