目的探讨CT结肠成像诊断结肠 息肉中放射科医师评估诊断的差异。方 法 收集2013年4月-2015年3月期间我院检 查的120例高度怀疑为结肠息肉患者的CT 结肠影像，由4位不同水平的放射科医师 (不知道纤维结肠镜结果)分别在使用和 不使用辅助诊断工具(计算机辅助检测， Computer-Aided Detection，CAD)的情 况下进行阅片，以纤维结肠镜检查为金标 准，观察不同水平医师在不同情况下对结 肠息肉检出的敏感性、特异性、准确性、 阳性预测值和阴性预测值。结果 同水平 医师在相同诊断条件下对结肠息肉检出 情况比较差异无明显的统计学意义(P＞ 0.05)；不同水平的医师在无辅助诊断工 具的情况下对结肠息肉检出情况比较差异 有明显的统计学意义(P＜0.05)；不同水 平的医师在使用辅助诊断工具的情况下对 结肠息肉检出情况比较差异无明显的统计 学意义(P＞0.05)；高年资水平的医师在 使用辅助诊断工具后，对结肠息肉的检出 率相对提高，但与不使用辅助诊断工具时 检出情况相比差异无明显的统计学意义(P ＞0.05)。结论 CT结肠成像诊断结肠息肉 评估受放射科医师的年资水平的影响很 大，通过采用CAD辅助诊断评估可以缩小 或消除由不同年资水平造成的诊断差异。

Objective To explore the use of colon CT imaging in the diagnosis of colon polyps radiologists to assess differences. Methods Collection in April 2013 to March 2015 period in our hospital between examination was highly suspected as colon polyps in 120 cases of patients with colon CT image data, by four different levels of radiologists in use and do not use the auxiliary diagnostic tool for reading, fiber colonoscopy as gold standard, at different levels of doctors in different cases of colon polyps detection sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results At the physician in the diagnosis of colon polyps detection under the condition of same comparison difference has no obvious statistical significance (P>0.05); Different levels of physicians in without auxiliary diagnostic tool for colon polyps detected situation is difference have significant statistical significance (P<0.05); Different levels of physicians in the use of auxiliary diagnostic tools of colon polyps detection under the condition of comparison difference has no obvious statistical significance (P>0.05); High qualification levels of physicians in the use of auxiliary diagnostic tools, relative improve detection rate of colon polyps, but with the auxiliary diagnostic tool is not used there was no obvious difference detection than statistical significance (P>0.05). Conclusion CT imaging in the diagnosis of colon colon polyps assessment greatly depends on the level of seniority of radiologists, by adopting CAD auxiliary diagnosis can reduce or eliminate differences.