不同读片方式下数字医学影像显示一致性研究
Kappa值；一致性分析；软读片；X线胶片,,],Kappa值；一致性分析；软读片；X线胶片,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 通过对临床大量硬读片和软读片诊断结果的分析，说明PACS系统在读片上的优越性以及不同读片方式之间的统计一致性，为诊断效果分析及放射科数字影像诊断的质量控制提供合乎统计规律的科学依据。方法 基于我院拥有的大量X线胶片数据，在保证取样随机性的前提下，选择合适的胶片取样数目(6000例)；在保证医生判读一致性的条件下，获取医生在不同读片方式下的诊断结果(阳性，阴性，可疑阳性)；利用Kappa方法对医生判读结果进行统计分析。结果 软读片方式杜绝了可疑阳性诊断结果的出现；软读片、专业灰度显示器及图像处理技术都可以提高诊断结果的阳性率；从Kappa值分析的角度，胶片与普显、胶片与专显、图像处理前后的普显、图像处理前后的专显之间有着几乎一致的诊断结果。 结论 软读片除了有易于保存与处理等优点外，我院现在采用的专业灰度显示器及对诊断影像进行图像处理有助于阳性率的提升。Kappa值的分析结果说明了我院现有诊断方式的可行性。[关键词] Kappa值；一致性分析；软读片；X线胶片
Study on agreement about digital medical imaging displaying in different reading methods
CUI Li，LV Donghui，ZHOU Lijiang，et al.Radiology Department of Shanghai Baoshan Central Hospital,Shanghai 201900,China
[Abstract] Objective By analyzing a large quantities of diagnostic results of reading Xray films and reading Xray pictures,it is easy to show that PACS system has advantages in reading pictures and statistical agreement exists among the different reading methods.The method has been proposed for analyzing the diagnostic results and controlling the qualities of digital medical images in radiological department in statistical meaning. Methods 6000 cases have been selected from the Xray films in our hospital based on the random sampling criterion and the diagnostic results (positive,suspected positive,negative) in different reading methods have been obtained by doctors.Kappa values have been computed according to doctors diagnostic results. Results Soft reading method,which avoids the appearances of suspected positive diagnosis results,special displays and imaging processing technology improve the positive rate of the diagnosis results.There are almost the same diagnosis results between films and common displays,films and special displays,common displays by image processing or not,special displays by image processing or not in the view of Kappa analysis.Conclusion Soft reading pictures are easy to store and process.Special displays and diagnostic imaging processing in our hospital help improve the positive rates.The statistical results based on Kappa values prove the feasibility of existing diagnostic methods in our hospital. ......
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