用于急性中风初步诊断的智能手机客户端-服务器远程放射学系统A Mitchell,J Ross %A Sharma,Pranshu %A Modi,Jayesh %A Simpson,Mark %A Thomas,Monroe %A Hill,Michael D %A Goyal,Mayank +影像信息学实验室，传统医学研究大楼，372室，3330医院路西北，卡尔加里，AB, T2N 4N1, 1 403 210 6667，rmitch@ucalgary.ca %K急性脑卒中%K远程放射学%K计算机断层扫描%K移动健康%K手机%D 2011 %7 06.05.2011 %9原始论文%J J医学互联网Res %G英文%X背景:急性缺血性脑卒中治疗的最新进展使图像的快速获取、可视化和解释成为患者积极预后的关键因素。我们开发了一种新的基于客户端-服务器架构的远程放射学系统，可以在当前一代智能手机设备(Apple iPhone或iPod Touch或Android手机)上快速访问交互式高级2-D和3-D可视化，而不需要将患者图像数据存储在设备上。相反，服务器加载并呈现患者图像，然后将呈现的帧传输到远程设备。目的:我们的目的是确定一种新的智能手机客户端-服务器远程放射学系统是否能够为急性中风的诊断提供足够的准确性和解释时间。方法:本研究为回顾性研究。我们从卡尔加里中风项目数据库中获得了120个最近连续的非对比计算机断层扫描(NCCT)脑部扫描和70个计算机断层扫描血管造影(CTA)脑部扫描。扫描结果由两名神经放射学家读取，其中一人在医学诊断工作站和iPod或iPhone(以下称为iOS设备)上读取，另一人仅在iOS设备上读取。NCCT脑扫描评估梗死早期征象，包括早期脑实质缺血改变和致密血管征象，并排除急性脑实质内出血和卒中模拟。CTA脑部扫描评估是否存在颅内血管阻塞。 The interpretations made on an iOS device were compared with those made at a workstation. The total interpretation times were recorded for both platforms. Interrater agreement was assessed. True positives, true negatives, false positives, and false negatives were obtained, and sensitivity, specificity, and accuracy of detecting the abnormalities on the iOS device were computed. Results: The sensitivity, specificity, and accuracy of detecting intraparenchymal hemorrhage were 100% using the iOS device with a perfect interrater agreement (kappa = 1). The sensitivity, specificity, and accuracy of detecting acute parenchymal ischemic change were 94.1%, 100%, and 98.09% respectively for reader 1 and 97.05%, 100%, and 99.04% for reader 2 with nearly perfect interrater agreement (kappa = .8). The sensitivity, specificity, and accuracy of detecting dense vessel sign were 100%, 95.4%, and 96.19% respectively for reader 1 and 72.2%, 100%, and 95.23% for reader 2 using the iOS device with a good interrater agreement (kappa = .69). The sensitivity, specificity, and accuracy of detecting vessel occlusion on CT angiography scans were 94.4%, 100%, and 98.46% respectively for both readers using the iOS device, with perfect interrater agreement (kappa = 1). No significant difference (P < .05) was noted in the interpretation time between the workstation and iOS device. Conclusion: The smartphone client-server teleradiology system appears promising and may have the potential to allow urgent management decisions in acute stroke. However, this study was retrospective, involved relatively few patient studies, and only two readers. Generalizing conclusions about its clinical utility, especially in other diagnostic use cases, should not be made until additional studies are performed. %M 21550961 %R 10.2196/jmir.1732 %U //www.mybigtv.com/2011/2/e31/ %U https://doi.org/10.2196/jmir.1732 %U http://www.ncbi.nlm.nih.gov/pubmed/21550961