三维建模辅助检出肺部磨玻璃密度结节的临床教学分析

doi:10.19983/j.issn.2096-8493.20230100

摘要/Abstract

摘要：

目的: 探讨胸部CT扫描三维解剖建模辅助肺部磨玻璃密度结节教学的效果,优化学员检出肺结节的学习过程。方法: 招募2023年1—2月于解放军总医院第八医学中心放射科实习的学员共42名,计算机对应学号生成随机数排序后随机分为三维建模组21名(奇数序号)和对照组21名(偶数序号)。两组学员均通过阅读教材和胸部CT扫描阅片学习肺部磨玻璃密度结节识别。三维建模组在阅读教材和阅片的基础上通过胸部增强CT扫描结果构建三维模型,学习结节与周围解剖组织的关系。每周学习结束时进行结节识别的技能考核,共8周。选取肺磨玻璃密度结节和正常的CT扫描数据各10例,要求两组学员对CT扫描数据进行阅片,报告是否发现结节。根据(正确发现肺结节例数+正确报告无肺结节例数)×5计算分值。比较两组考核得分。结果: 两组学员每周考核肺结节检出能力的分值呈上升趋势,三维建模组得分中位数(四分位数)由50(45,55)上升至95(90,95),对照组得分中位数(四分位数)由45(45,55)上升至90(80,95)。三维建模组第1、2、3、4、5、6、7周考核分值得分[中位数(四分位数)]高于对照组[50(45, 55), 70(65, 70),75 (70, 80),75(75, 85),90 (85, 95),95(90, 95),95(90, 95)和 45(45, 55),60(60, 65),65(60, 70),70(70, 75),75(70, 80),85 (85, 95),85(85, 95); U值分别为306.499,334.001,336.478,352.007,411.002,325.492,310.477;P值分别为0.025,0.003,0.003,<0.001,<0.001,0.006,0.019)。两组第8周考核得分差异无统计学意义(U=283.491,P=0.103)。结论: 传统教学与三维建模辅助教学方法均能提高临床学员对肺部磨玻璃密度结节的检出能力,三维建模辅助教学能够快速提高临床学员对肺部磨玻璃密度结节的检出能力,节约学习时间。

关键词: 肺肿瘤, 结节病, 肺, 体层摄影术, X线计算机, 成像, 三维, 教学

Abstract:

Objective: To explore the effects of using three-dimensional (3D) anatomical model based on pulmonary CT to promote education for detecting ground glass nodules and improve the learning procedure of trainees. Methods: We recruited 42 trainees during their intern year (2023 year) at the Department of Radiology of The Eighth Medical Center of Chinese PLA General Hospital. The trainees were randomly allocated to a 3D model group with 21 cases (odd NO) and a control group with 21 cases (even NO) following sorts of computer-generated random numbers corresponding to student ID. Both groups learned to identify pulmonary ground glass nodules on non-contrast CT images by reading educational materials and radiographs. For contrast, the 3D model group learned the relationship between a pulmonary nodule and its surrounding anatomical tissues by observing a 3D model based on pulmonary contrast CT. We assessed trainees’ ability of identifying pulmonary nodules by conducting exams weekly during the 8 weeks of education. CT data of 10 cases with pulmonary ground glass nodules and 10 normal cases were selected randomly for assessment. The exam scores were calculated as (number of correctly detecting nodules+number of correctly reporting no nodule)×5 which were then compared between the two groups. Results: The weekly scores showed an increasing trend. The median (IQR) score of the 3D model group and control group increased from 50 (45, 55) and 45 (45, 55) to 95 (90, 95) and 90 (80, 95), respectively. The scores of the 3D model group at weeks 1, 2, 3, 4, 5, 6, 7 were higher than those of control group (50 (45, 55), 70 (65, 70), 75 (70, 80), 75 (75, 85), 90 (85, 95), 95 (90, 95), 95 (90, 95) vs 45 (45, 55), 60 (60, 65), 65 (60, 70), 70 (70, 75), 75 (70, 80), 85 (85, 95), 85 (85, 95); U value: 306.499, 334.001, 336.478, 352.007, 411.002, 325.492, 310.477; P value: 0.025, 0.003, 0.003, <0.001, <0.001, 0.006, 0.019)). The difference in score between the two groups at week 8 failed to reach statistical significance (U=283.491, P=0.103). Conclusion: Education assisted by 3D Models can promote trainees to rapidly increase their ability of identifying pulmonary ground glass nodules, thus could save learning time.

Key words: Lung neoplasms, Sarcoidosis, pulmonary, Tomography, X-Ray computed, Imaging, three-dimensional, Teaching

中图分类号:

汤可, 袁小东, 张来星. 三维建模辅助检出肺部磨玻璃密度结节的临床教学分析[J]. 结核与肺部疾病杂志, 2023, 4(5): 346-351. doi: 10.19983/j.issn.2096-8493.20230100

Tang Ke, Yuan Xiaodong, Zhang Laixing. Clinical education assisted by three-dimensional model for detecting pulmonary ground glass nodule[J]. Journal of Tuberculosis and Lung Disease, 2023, 4(5): 346-351. doi: 10.19983/j.issn.2096-8493.20230100

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