摘要
目的探讨数字化X线摄影中双能量减影技术检查喉部肿瘤的价值。方法回顾性对比分析已被CT和病理证实的50例喉部肿瘤(声门癌34例,声门上区肿瘤10例,声门下区肿瘤6例)的双能量减影和常规DR喉部正侧位图像,3名高年资医师用5级法:肯定有、可能有、不确定、可能没有、肯定没有,独立判断是否有喉部病变存在,计算他们双能量减影与常规DR的ROC曲线下的面积及其标准误,并进行比较。结果三位医师阅片的常规喉部DR的Az值分别为0.642,0.656,0.649,而能量减影为0.796,0.805,0.822,双能量减影ROC曲线下的面积分别为明显高于常规DR检查,有高度的统计学意义(p<0.01),双能量减影技术对喉部肿瘤的显示明显优于常规DR。结论常规DR由于受周围骨组织及软组织遮挡对喉部病变显示较差,初次检查时极易误漏诊病变,从而延误病情,双能量减影技术可以有效地去除骨组织及软组织的影响,并通过多种后处理技术使病变更清晰显示,这项技术的应用有望提高普通放射学对喉部肿瘤的初查诊断率,有利于临床进一步检查和治疗。
Objective To explore the clinical value of DR dual-energy subtraction on diagnosing throat neoplasm, Methods DR dual-energy subtraction filmsand general X-ray films of 50 cases with throat neoplasm confirmed by CT and pathology were analysed retrospectively by 3 seniority doctors. The presence or absence of throat diseases were investigated with a five-point confidence -rating scale： definitely positive; probably positive; indeterminate; probably negative and definitely negative. ROC curves of them was calculated, then compared with the Az values and standard error of general X-ray film and soft film of dual-energy subtraction. Results The mean Az values of three radiologists were 0.642. 0.656. 0.649 for general X-ray film and 0.796, 0.805, 0.822 for dual-energy subtraction. There were significant differences between general X-ray film and dual-energy subtraction in the detection of throat neoplasm in the Receiver Operating Characteristic （ROC） analysis （3〈0.01）. Dual-energy subtraction technique is obviously excelled to traditional X-ray examination on displaying throat neoplasm. Conclusion The throat neoplasm are usually misdiagnosed or missed out by traditional X-ray examination because of the shelfting of surrounding bone tissue and soft tissue, which will dally over to treat the diseases. The DR dual-energy subtraction can eliminate the influnce of bone tissue efficiently and show pathological changes more clearly through multiple postprocessing technique. The using of this technique can improve the displaying of X-ray plain film to the throat neoplasm, and is benefit to clinical therapy.
出处
《上海医学影像》
2008年第4期304-305,323,共3页
Shanghai Medical Imaging
