Woodard P K, Slone R M, Sagel S S, Fleishman M J, Gutierrez F R, Reiker G G, Pilgram T K, Jost R G
Electronic Radiology Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.
Radiology. 1998 Dec;209(3):705-9. doi: 10.1148/radiology.209.3.9844662.
To compare hard-copy digital chest radiographs obtained with a selenium-based system with wide-latitude asymmetric screen-film radiographs for detection of pulmonary nodules.
Fifty patients undergoing thoracic computed tomography (CT) for suspected pulmonary nodules were recruited to undergo both digital and screen-film posteroanterior (PA) and lateral chest radiography. Three chest radiologists blinded to the CT results independently reviewed each digital and screen-film radiograph, identified each nodule, and graded their confidence for its presence.
Seventy-eight pulmonary nodules (mean diameter, 1.5 cm; range, 0.5-3.5 cm; 62 soft tissue, 16 calcified) were identified with CT in 34 patients, while 16 patients had clear lungs. The mean sensitivity for the detection of all nodules by all readers (PA and lateral) was 66% (95% Cl, 54%, 76%) for digital radiographs and 64% (95% Cl, 52%, 74%) for screen-film radiographs. Differences between the two techniques were not statistically significant (P > .05, Student t test). There was no difference in mean false-positive-true-positive ratios (PA, 0.35; lateral, 0.53) or positive predictive values (PA, 74%; lateral, 65%), and no significant difference (P > .05) was seen in mean reader confidence rating.
In detecting pulmonary nodules, radiologists perform comparably with selenium-based digital and wide-latitude asymmetric screen-film radiographs.
比较基于硒的系统所获得的硬拷贝数字胸部X线片与宽纬度非对称增感屏-胶片X线片在检测肺结节方面的效果。
招募50例因疑似肺结节而接受胸部计算机断层扫描（CT）的患者，对其进行数字和增感屏-胶片后前位（PA）及侧位胸部X线摄影。三位对CT结果不知情的胸部放射科医生独立审阅每张数字和增感屏-胶片X线片，识别每个结节，并对其存在的可信度进行分级。
34例患者经CT检查发现78个肺结节（平均直径1.5 cm；范围0.5 - 3.5 cm；62个软组织结节，16个钙化结节），16例患者肺部清晰。所有阅片者（PA位和侧位）对所有结节检测的数字X线片平均敏感度为66%（95%可信区间，54%，76%），增感屏-胶片X线片平均敏感度为64%（95%可信区间，52%，74%）。两种技术之间的差异无统计学意义（P > 0.05，学生t检验）。平均假阳性-真阳性率（PA位为0.35；侧位为0.53）或阳性预测值（PA位为74%；侧位为65%）无差异，阅片者平均可信度评级也无显著差异（P > 0.05）。
在检测肺结节方面，放射科医生使用基于硒的数字X线片和宽纬度非对称增感屏-胶片X线片表现相当。
