目的 通比较CAD、医生双阅片、 医生结合CAD阅片三种CT筛查肺结节方 式，评价计算机辅助检测系统(CAD)在CT 筛查肺结节中的应用价值。方法 从CT扫 描的无症状体检者中，应用随机抽样方法 抽取60例肺结节患者。分别使用3种方式 阅读图像，方法A：应用CAD软件对图像进 行自动诊断；方法B：由2名放射科医生共 同阅读图像并以一致意见作为诊断；方 法C：由另外1名同等年资的放射科医生 结合CAD软件阅读图像并做出诊断。结节 参照标准由3位主任医生共同拟定。应用 χ2 检验分析三种阅读方式灵敏度是否存 在差异，P＜0.05为差异有统计学差异。 结果 CAD、医生双阅片、医生结合CAD三 种方式肺结节检出灵敏度分别为75.1％、 73.8％、87.3％。医生结合CAD方式肺结 节检出灵敏度显著高于CAD、医生双阅片 方式(P=0.001,P=0.0003)。CAD与医生双 阅片方式之间肺结节检出灵敏度没有显著 差异(P=0.74)。结论 CAD系统可以提高 放射科医生肺结节检出能力，且医生结 合CAD诊断方式优于同年资医生双阅片方 式。

Objective By comparing three reading methods of CT screening for lung nodules: CAD, double reading and the radiologist combined with CAD. To evaluation the application of computer aided testing system (CAD) in CT screening for lung nodules. Methods 60subjects diagnosed with lung nodules undergoing the rountine-dose screening CT examination were random selected. Three methods were used, Method A: using CAD system to identify the image automatically. Methods B: two radiologists reading all images , record the results and with 2 agreement as the final diagnosis; Method C: by another radiologist as the same work experience with CAD system, recorded the detection as the final diagnosis. The reference standard was determined by three raiologists. χ2 test was performed to test whether there is significant difference between sensitivities of three reading modes, and statistical significances were defined as P＜0.05. Results CAD system, double reading, the radiologist with CAD method of pulmonary nodules detection sensitivity was 75.1％,73.8％ and 87.3％ respectively. The sensitivities of pulmonary nodule detection of the radiologist combined with CAD was significantly higher than CAD and double reading methods (P=0.001,P=0.0003).There were no significant sensitivity diffrernce between CAD and double reading method (P=0.74). Conclusion The CAD system can improve the ability of detection pulmonary nodules of the radiologist, and radiologists in combination with CAD diagnosis method is better than double reading method with same work experience.