To observe the supporting effect of a computer-aided detection (CAD) algorithm for doctors who lack of experience in detection of acute pulmonary embolism (PE) by CT pulmonary angiography (CTPA), Methods Consecutive patients with suspected PE and (or) deep venous thrombosis who underwent CTPA between July 2010 and December 2010 were reviewed. All CTPA images were evaluated by three experienced doctors and taken as the reference standards. The position and number of embolus were evaluated by two doctors who lack of experience, and the same doctors did the work again assisted by CAD after 3 months. Both from patients and embolus, the accuracy of the doctors who lack of experience in diagnose PE with and without CAD were evaluated. Results A total of 267 patients were enrolled in the study. There were 81 patients and 555 embolus detected by the experience doctors, and 67 patients and 493 embolus were detected by doctors lack of experience without CAD, the sensitivity of levels in the pulmonary artery (trunk, leaves, seg-mental and subsegmental) was 100% (26/26), 98.63% (72/73), 89.76% (228/254) and 82. 67% (167/202), while the specificity was 100% (775/775), 99.80% (1526/1529), 99.55% (5063/5086) and 99. 50% (10 426/10 478), respectively. Meanwhile, 75 patients and 523 embolus were detected by the doctors lack of experience with CAD, the sensitivity of levels in the pulmonary artery (trunk, leaves, segmental and subsegmental) was 100% (26/26), 100% (73/73), 92. 12 % (234/254) and 94.06% (190/202), while the specificity was 100% (775/775), 99.74% (1525/1529), 99.47% (5059/ 5086) and 99. 32% (10 407/10 478), respectively. Conclusion CAD can significantly improve the sensitivity for doctors lack of experience in detecting PE, especially for subsegmental thrombus.%目的 评价计算机辅助检测(CAD)技术提高低年资医师在CT肺血管造影(CTPA)检查中诊断急性肺栓塞能力的价值.方法 连续收集2010年7-12月间接受CTPA检查的可疑肺栓塞或下肢深静脉血栓患者.以3名高年资放射科医师做出的一致性诊断作为参考标准,另由2名缺乏经验的低年资医师(低年资医师组)共同记录栓子的位置、数目.3个月后,此2名低年资医师借助CAD(低年资医师+CAD组)对患者重新进行评估.分别从患者数和栓子数两方面比较低年资医师组和低年资医师+CAD组诊断急性肺栓塞的差异.结果 共267例患者纳入研究.高年资医师诊断急性肺栓塞患者81例,检出栓子555个.低年资医师组检出患者67例,栓子493个,在肺动脉各级(肺动脉主干、叶、段、亚段)的敏感度分别为100％(26/26)、98.63％ (72/73)、89.76％ (228/254)和82.67％(167/202),特异度分别为100％(775/775)、99.80％(1526/1529) 、99.55％(5063/5086)和99.50％ (10426/10478);低年资医师+CAD组检出患者75例,栓子523个,在肺动脉各级的敏感度分别为100％(26/26)、100％(73/73)、92.12％(234/254)和94.06％(190/202),特异度分别为100％(775/775)、99.74％(1525/1529)、99.47％(5059/5086)和99.32％(10407/10478).结论 借助于CAD,低年资医师诊断肺栓塞的准确性得到显著提高,尤其是对于检出亚段肺动脉栓子.
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