【作者】 刘亮；

【导师】 张惠茅；

【作者基本信息】 吉林大学 ， 影像医学与核医学， 2012， 硕士

【摘要】 目的：初步探讨计算机辅助检测（Computer-aided Detection，CAD）联合CT结肠成像(CT colonography，CTC)在结肠息肉的诊断价值。方法：回顾性分析60例采用东芝Aquilion One进行仰卧位和俯卧位扫描后CTC数据（纤维结肠镜证实49例至少有1个直径≥0.5cm息肉，11例正常）。由4位不知情的不同水平放射科医师（2位高年资医师和2位低年资医师）分别在不使用和使用CAD系统情况下独立阅片检测结肠息肉，统计分析检出息肉的敏感度、特异度、阳性预测值、阴性预测值、检出息肉的准确性以及受试者工作特征曲线(ROC曲线)下面积(Az)的变化差异。结果：CAD全面提高了高年资医师与低年资医师对结肠息肉诊断的敏感度、特异度、阳性预测值、阴性预测值、准确性及Az值。通过应用CAD，高年资医师与低年资医师对直径5-9mm的息肉诊断的敏感度分别由82%、40%提高到92%、83%（P＞0.05，P＜0.001）。在CAD的辅助下，高年资医师与低年资医师对于息肉诊断的假阳性率、假阴性率均有不同程度的下降。CAD没有检测出的16例无蒂息肉中，3例直径≥1.0cm，13例直径5-9mm，11例为扁平型息肉。结论：CAD联合CTC可提高不同年资医师对结肠息肉的检出能力，对低年资医师尤为显著。但CAD在扁平型息肉检出方面具有局限性。更多还原

【Abstract】 Objective：To evaluate the application value of CT colonography withcomputer-aided detection (CAD) in detection of colonic polypsMethod: CTC was performed with a Toshiba Aquilion One scanner.60patients were included in this study，in which the result of endoscopic detectionshow that49patients were positive for at least one polyp of≥0.5cm in size andthe other11patients were negative. Date of CTC were retrospectivelyreviewed first without CAD and then with CAD by four radiologists (two wereexperienced and another two inexperienced) blinded to colonoscopy findings.The sensitivity, specificity, positive predictive value, negative predictive value,and accuracy of detected colonic polyps, as well as the areas under the ROCcurves (Az value) with and without CAD were calculated..Results: CAD increased the overall sensitivity, specificity, positivepredictive value, negative predictive value and accuracy of the colonic polypsdetected by experienced and inexperienced readers. The sensitivity indetecting small polyps (5–9mm) with CAD in experienced and inexperiencedreaders increased from82%and40%to92%and83%, respectively (P>0.05and P <0.001). With the use of CAD, the overall false positive rate and falsenegative rate for the detection of polyps by experienced and inexperiencedreaders decreased in different degrees. Among16sessile polyps not detected byCAD, three were≥1.0cm, thirteen were5–9mm in diameter, and eleven wereflat-shaped lesions.Conclusion: The application of CTC with CAD can increase the ability todetect colonic polyps, particularly for inexperienced readers. However, CAD isof limited value for the detection of flat polyps.更多还原