胸部影像学检查人工智能辅助读片技术在肺结核患者发现中的应用专家共识

doi:10.19982/j.issn.1000-6621.20250234

摘要/Abstract

摘要：

胸部影像学检查是肺结核筛查和诊断的重要工具。计算机辅助检测(computer-aided detection,CAD)技术的发展为应用胸部影像学检查进行肺结核的主动发现带来新契机。本共识由中国防痨协会影像专业分会、中华医学会结核病学分会、中国防痨协会标准化专业分会和中国防痨协会结核病控制专业分会联合制定,并得到《中国防痨杂志》期刊社的支持。本共识在国际实践指南平台注册,制订过程遵循方法学原则,由多领域专家协作、结合世界卫生组织相关技术指南和我国应用实践完成。本共识阐述了CAD工作原理,介绍了国内外15款基于胸部X线平片(chest X-ray,CXR)的肺结核CAD软件性能;给出了CXR-CAD在医疗机构就诊患者以及社区和重点场所人群的肺结核筛查中的应用推荐;介绍了基于CT的CAD在肺结核诊断中的研发进展;提出了目前CAD在肺结核患者主动发现中存在的局限性及未来研究方向。

关键词: 结核,肺, 人工智能, 计算机辅助检测, 胸部X线平片, 胸部计算机断层扫描, 专家共识

Abstract:

Thoracic imaging is an important tool for the screening and diagnosis of tuberculosis. With the development of computer-aided detection (CAD) technology, new opportunities have emerged for the active finding of tuberculosis using thoracic imaging. This consensus was jointly developed by Imaging Professional Branch of Chinese Antituberculosis Association;Society of Tuberculosis, Chinese Medical Association; Standardization Professional Branch of Chinese Antituberculosis Association and Tuberculosis Control Professional Branch of Chinese Antituberculosis Association. It was supported by the Chinese Journal of Antituberculosis Publishing House and has been registered on the international practice guideline platform. The development of this consensus followed methodological principles, involving collaboration among experts from multiple fields and combining the World Health Organization’s relevant technical guidelines with the experiences of practical in China. The consensus explains the working principles of CAD, introduces the performance of 15 domestic and international CAD software programs for tuberculosis based on chest X-ray films (CXR), provides recommendations for the application of CXR-CAD in tuberculosis screening among patients visiting medical institutions as well as population with high risk of tuberculosis in communities, describes the research progress of CT based CAD in the diagnosis of tuberculosis, and highlights the current limitations of CAD in the active finding of tuberculosis patients and future research priorities.

Key words: Tuberculosis, pulmonary, Artificial intelligence, Computer-aided detection, Chest X-ray, Chest computed tomography, Expert consensus

中图分类号:

R81
R521

中国防痨协会影像专业分会, 中华医学会结核病学分会, 中国防痨协会标准化专业分会, 中国防痨协会结核病控制专业分会. 胸部影像学检查人工智能辅助读片技术在肺结核患者发现中的应用专家共识[J]. 中国防痨杂志, 2025, 47(9): 1093-1104. doi: 10.19982/j.issn.1000-6621.20250234

Imaging Professional Branch of Chinese Antituberculosis Association , Society of Tuberculosis, Chinese Medical Association , Standardization Professional Branch of Chinese Antituberculosis Association , Tuberculosis Control Professional Branch of Chinese Antituberculosis Association . Expert consensus on the application of artificial intelligence assisted image reading technology in the detection of pulmonary tuberculosis patients in chest imaging examination[J]. Chinese Journal of Antituberculosis, 2025, 47(9): 1093-1104. doi: 10.19982/j.issn.1000-6621.20250234

图/表 3

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证据质量分级	具体描述	表达字母
高	非常确信真实的效应值接近效应估计,未来研究几乎不可能改变现有评价结果的可信度	A
中	对效应估计值有中等程度的信心:真实值有可能接近估计值,但仍存在二者大小相同的可能性;未来研究可能对现有评估有重要影响,可能改变评价结果的可信度	B
低	对效应估计值的确信程度有限:真实值可能与估计值大不相同;未来研究很有可能对现有评估有重要影响,改变评估结果可信度的可能性较大	C
极低	对效应估计值的确信程度有限:真实值可能与估计值大不相同;未来研究很有可能对现有评估有重要影响,改变评估结果可信度的可能性较大	D

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