TY - T1的变量放射性肺结节评估导致不同的管理建议JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.01359 -2018欧元六世- 52 - 6 SP - 1801359 AU - Nair Arjun AU -巴特利特,艾米丽·c . AU -沃尔什,西蒙L.F. AU -威尔斯,Athol美国的非盟- Navani Neal盟——HardavellaGeorgia AU - Bhalla, Sanjeev AU - Calandriello, Lucio AU - Devaraj, Anand AU - Goo, Jin Mo AU - Klein, Jeffrey S. AU - MacMahon, Heber AU - Schaefer-Prokop, C.M. AU - Seo, Joon-Beom AU - Sverzellati, Nicola AU - Desai, Sujal R. A2，N2 - CT (computed tomography, CT)中偶然发现的肺结节的放射学评价影响管理。我们评估了1)肺结节特征的国际影像学变化;2)假设导则衍生的管理;3)放射科医生的管理建议。来自25个国家的107名放射科医生评估了69个ct检出的结节，记录如下:1)首选成分(实性、部分实性或毛玻璃状，有百分比置信度);2)形态学特征;3)尺寸;4)建议管理; and 5) decision-influencing factors. We modelled hypothetical management decisions on the 2005 and updated 2017 Fleischner Society, and both liberal and parsimonious interpretations of the British Thoracic Society 2015 guidelines.Overall agreement for first-choice nodule composition was good (Fleiss' κ=0.65), but poorest for part-solid nodules (weighted κ 0.62, interquartile range 0.50–0.71). Morphological variables, including spiculation (κ=0.35), showed poor-to-moderate agreement (κ=0.23–0.53). Variation in diameter was greatest at key thresholds (5 mm and 6 mm). Agreement for radiologists' recommendations was poor (κ=0.30); 21% disagreed with the majority. Although agreement within the four guideline-modelled management strategies was good (κ=0.63–0.73), 5–10% of radiologists would disagree with majority decisions if they applied guidelines strictly.Agreement was lowest for part-solid nodules, while significant measurement variation exists at important size thresholds. These variations resulted in generally good agreement for guideline-modelled management, but poor agreement for radiologists' actual recommendations.Radiological variations in pulmonary nodule evaluation translate into good overall agreement for guideline-modelled management, but poor agreement for radiologists' actual recommendations: 21% of radiologists can disagree with majority decisions http://ow.ly/bPOu30mcRYA ER -