Brägger U, Bürgin W, Marconi M, Häsler R U, Lang N P
Department of Periodontology and Fixed Prosthodontics, University of Berne, Switzerland.
J Periodontal Res. 1994 Mar;29(2):95-102. doi: 10.1111/j.1600-0765.1994.tb01096.x.
This study evaluated the influence of the image processing step of digital subtraction images on inter- and intraexaminer agreement in the interpretation of alveolar bone changes. 52 pairs of standardized radiographs from various clinical trials were included. Six dentists were invited to interpret the images projected as slides in random order. Display one demonstrated the slide of the digitized baseline radiograph and the follow-up image. Display two showed the regular digital subtraction image. Display three represented a grey level contrast enhanced version and displays four and five were pseudo/color enhanced subtraction images. Applying kappa-statistics and multiple regression analysis it was demonstrated that better agreements were obtained when the two color coded displays of subtraction images were shown to the interpreters. The image interpretation was performed in two series. For the first evaluation the interpreters were not informed about the therapy provided nor the time elapsed between taking the pairs of standardized radiographs. In the second series this information was provided. It could be demonstrated that the agreement in the diagnosis of bone change was less influenced by the knowledge about the clinical information if the two color-converted versions of subtracted images were evaluated. Thus, it was concluded that image processing of subtraction images using color enhancement might improve agreement in the diagnostic task. The color coded images were less influenced by the bias in the interpretation of an expected change. The decision making process might be more objective when using color enhanced subtraction images.
本研究评估了数字减影图像的图像处理步骤对牙槽骨变化解读中检查者间和检查者内一致性的影响。纳入了来自各种临床试验的52对标准化X光片。邀请了六位牙医以随机顺序解读以幻灯片形式呈现的图像。展示一呈现数字化基线X光片和随访图像的幻灯片。展示二显示常规数字减影图像。展示三呈现灰度对比度增强版本，展示四和展示五是伪彩色/彩色增强减影图像。应用kappa统计和多元回归分析表明，当向解读人员展示减影图像的两种颜色编码显示时，能获得更好的一致性。图像解读分两个系列进行。在第一次评估中，未告知解读人员所提供的治疗方法以及拍摄这对标准化X光片之间经过的时间。在第二个系列中提供了这些信息。可以证明，如果评估减影图像的两种颜色转换版本，骨变化诊断的一致性受临床信息知识的影响较小。因此，得出结论，使用颜色增强对减影图像进行图像处理可能会提高诊断任务中的一致性。颜色编码图像受预期变化解读偏差的影响较小。使用颜色增强减影图像时，决策过程可能更客观。
