Kundel H L, Gefter W, Aronchick J, Miller W, Hatabu H, Whitfill C H, Miller W
Department of Radiology, Pendergrass Diagnostic Research Laboratory, University of Pennsylvania Medical School, Philadelphia 19104-6086, USA.
Radiology. 1997 Dec;205(3):859-63. doi: 10.1148/radiology.205.3.9393548.
To compare the clinical diagnostic accuracy of hard-copy readings of screen-film bedside chest radiographs and both hard- and soft-copy readings of bedside chest computed radiographs obtained in a medical intensive care unit.
Two samples of 95 cases were assembled from chest images obtained in 541 patients with either screen-film radiography or computed radiography. The cases were stratified according to the clinical problem for which the examination was ordered; the corresponding diagnosis was verified by a panel of two or three radiologists. Four radiologists blindly read the hard-copy images obtained with screen-film or computed radiography. Six months later, the radiologists read the computed radiographs by using an 8-bit, 1,684 x 2,048-pixel display. The data were analyzed by using multireader-multicase receiver operating characteristic (ROC) analysis of variance.
No statistically significant differences in the area under the ROC curve were found between any of the methods.
The results provide some justification for using bedside chest computed radiography and for reading soft-copy images from a high-quality display.
比较在医疗重症监护病房中获得的床边胸部屏-片X线照片的硬拷贝阅片以及床边胸部计算机X线照片的硬拷贝和软拷贝阅片的临床诊断准确性。
从541例行屏-片X线摄影或计算机X线摄影的患者的胸部图像中收集了两个包含95例病例的样本。根据检查所针对的临床问题对病例进行分层；由两到三名放射科医生组成的小组核实相应诊断。四名放射科医生对屏-片或计算机X线摄影获得的硬拷贝图像进行盲法阅片。六个月后，放射科医生使用8位、1684×2048像素的显示器对计算机X线照片进行阅片。采用多阅片者-多病例接受者操作特征（ROC）方差分析对数据进行分析。
在任何方法之间，ROC曲线下面积均未发现统计学上的显著差异。
研究结果为使用床边胸部计算机X线摄影以及从高质量显示器读取软拷贝图像提供了一定的依据。
