% 0期刊文章% Nair, Arjun %巴特利特,艾米丽·c·%沃尔什,西蒙L.F. %井,Navani Athol美国的%,Neal % Hardavella,格鲁吉亚% Bhalla), (Sanjeev % Calandriello,卢西奥% Devaraj, Anand %咕,金钼%克莱因,Jeffrey s . % mcmahon,希Schaefer-Prokop %, %一个Seo, Joon-Beom % Sverzellati,尼古拉%德赛,Sujal r . %,《欧洲呼吸杂志》对计算机断层扫描(CT)偶然发现的肺结节的放射学评价会影响治疗。我们评估了肺结节特征的国际放射学变异;2)假想的指南衍生型管理;3)放射科医生的管理建议。来自25个国家的107名放射科医师对69个ct检测结节进行了评估，记录:1)首选成分(固体、部分固体或毛玻璃，有百分比可信度);2)形态学特征;3)尺寸;4)建议管理;(5)决策影响因素。 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 %U //www.qdcxjkg.com/content/erj/52/6/1801359.full.pdf