颅缝早闭：三维CT表现的诊断性影像学
Craniosynostosis: diagnostic imaging with three-dimensional CT presentation.
作者信息
Vannier M W, Pilgram T K, Marsh J L, Kraemer B B, Rayne S C, Gado M H, Moran C J, McAlister W H, Shackelford G D, Hardesty R A
机构信息
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
出版信息
AJNR Am J Neuroradiol. 1994 Nov;15(10):1861-9.
PURPOSE
To measure diagnostic performance and preference of two three-dimensional CT reconstruction modalities (voxel-gradient and surface-projection) displayed two ways (conventional and unwrapped) in craniosynostosis confirmed by surgical inspection and histologic analysis of resected sutures.
METHODS
High-resolution 2-mm contiguous CT sections were obtained and three-dimensional reconstruction images generated for 25 infants and children with skull deformities before surgical treatment of craniosynostosis. Two pediatric radiologists and two neuroradiologists first ranked images by their own preferences for diagnostic use. Then they diagnosed craniosynostosis from images presented in random order and blinded. The standard of reference was inspection during surgery and histologic evaluation of excised sutures. Finally, reviewers repeated their subjective preference tests.
RESULTS
The least experienced radiologist had 100% sensitivity for all imaging modalities and specificities ranging from 43% to 83%. The two most experienced radiologists performed nearly identically, with sensitivities of 96% and specificities of 100%. After performing diagnostic tasks using all image types, all radiologists preferred conventional surface projections.
CONCLUSION
Experienced readers can achieve nearly perfect diagnostic performance using the latest three-dimensional CT reconstruction images, making it a contribution to the diagnostic process. Although performance is nearly identical for all modalities, readers strongly prefer conventionally presented surface-projection images.
目的
通过手术检查和切除缝合线的组织学分析确诊颅缝早闭，测量以两种方式（传统方式和展开方式）显示的两种三维CT重建模式（体素梯度模式和表面投影模式）的诊断性能和偏好。
方法
获取25例颅缝早闭手术治疗前患有颅骨畸形的婴幼儿的2毫米连续高分辨率CT图像，并生成三维重建图像。两名儿科放射科医生和两名神经放射科医生首先根据自己对诊断用途的偏好对图像进行排序。然后他们对随机呈现且不知情的图像进行颅缝早闭的诊断。参考标准是手术中的检查和切除缝合线的组织学评估。最后，评估人员重复他们的主观偏好测试。
结果
经验最少的放射科医生对所有成像模式的敏感度均为100%，特异度在43%至83%之间。两名经验最丰富的放射科医生表现几乎相同，敏感度为96%，特异度为100%。在使用所有图像类型完成诊断任务后，所有放射科医生都更喜欢传统的表面投影图像。
结论
经验丰富的读者使用最新的三维CT重建图像可实现近乎完美的诊断性能，这对诊断过程有帮助。虽然所有模式的性能几乎相同，但读者强烈偏好传统呈现的表面投影图像。
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