Itouji E, Kono M, Adachi S, Yamasaki K, Kusumoto M, Sakai E, Endo M, Nakamura T
Department of Radiology, Kobe University, School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1993 Jun 25;53(6):655-66.
To clarify the clinical utility of computed radiography (CR) for the diagnosis of lung cancer, several kinds of image-processed CR images were compared with conventional radiographs (CXR). The images in the three patients with peripheral lung cancer were processed by the following six types: 1) processing close to CXR (plain CR), 2) wide latitude and high frequency emphasis (wide CR), 3) advanced high frequency emphasis (HE-CR), 4) lower frequency emphasis (LE-CR), 5) single exposure dual energy subtraction (ES) and 6) ES with lower frequency emphasis (LE-ES). In the two cases of hilar lung cancer, 1) plain CR, 2) wide CR, 3) CR tomographs similar to CXR tomographs (plain CR-TOMO) and 4) high frequency emphasized CR tomographs (HE-CR-TOMO) were processed. Twenty-six radiologists rated the image-processed CR images using a 5 point rating scale method. The following results were found for the evaluation of lung anatomy: almost all image-processed CR images were equal or superior to CXR; especially scores for plain CR were better than those for CXR in all anatomical structures studied; scores for ES were superior to those for plain CR in the bilateral main bronchi, left upper lobe bronchus and right paratracheal stripe; and scores for CR tomographs were better than those for CXR tomographs. In peripheral lung cancer, plain CR and ES were superior to CXR. Especially ES had the best scores. In hilar lung cancer, plain CR and CR tomographs were judged better than CXR and CXR tomographs. These findings indicate the usefulness of CR images for the diagnosis of lung cancer.
为阐明计算机X线摄影（CR）在肺癌诊断中的临床应用价值，将几种经过图像处理的CR图像与传统X线胸片（CXR）进行了比较。对3例周围型肺癌患者的图像进行了以下六种类型的处理：1）接近CXR的处理（普通CR）；2）宽宽容度和高频增强（宽CR）；3）高级高频增强（HE-CR）；4）低频增强（LE-CR）；5）单次曝光双能减影（ES）；6）低频增强的ES（LE-ES）。对2例中心型肺癌患者的图像进行了以下处理：1）普通CR；2）宽CR；3）类似于CXR断层摄影的CR断层摄影（普通CR-TOMO）；4）高频增强的CR断层摄影（HE-CR-TOMO）。26名放射科医生采用5分制评分法对经过图像处理的CR图像进行评分。在肺部解剖结构评估方面发现以下结果：几乎所有经过图像处理的CR图像与CXR相当或更优；尤其是普通CR在所有研究的解剖结构中的评分均优于CXR；ES在双侧主支气管、左上叶支气管和右气管旁条纹处的评分优于普通CR；CR断层摄影的评分优于CXR断层摄影。在周围型肺癌中，普通CR和ES优于CXR。尤其是ES的评分最佳。在中心型肺癌中，普通CR和CR断层摄影被判定优于CXR和CXR断层摄影。这些结果表明CR图像在肺癌诊断中具有应用价值。
