TY -的AU -米切尔,J·罗斯盟,Sharma Pranshu AU -莫迪,可以非盟-辛普森,马克盟——托马斯·门罗盟-希尔,迈克尔•D AU - Goyal玛雅PY - 2011 DA - 2011/05/06 TI -智能手机客户端-服务器电视医疗系统的主要诊断急性中风乔- J地中海互联网Res SP - e31六世- 13 - 2 KW -急性中风KW -电视医疗KW -计算机断层扫描KW - mhealth KW -手机AB -背景:急性缺血性脑卒中治疗的最新进展使得图像的快速获取、可视化和解释成为患者积极预后的关键因素。我们开发了一种基于客户端-服务器架构的新型远程放射学系统，可以在当前一代智能手机设备(苹果iPhone或iPod Touch或Android手机)上快速访问交互式高级2d和3d可视化，而无需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个新的智能手机客户端-服务器远程放射学系统是否能够提供足够的诊断急性中风的准确性和解释时间。方法: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)头部扫描。扫描结果由两名神经放射科医生读取，其中一名在医疗诊断工作站和iPod或iPhone(以下简称iOS设备)上读取，另一名仅在iOS设备上读取。NCCT脑部扫描评估梗死的早期征象，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脑卒中模拟。CTA脑部扫描评估颅内血管阻塞。 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. SN - 1438-8871 UR - //www.mybigtv.com/2011/2/e31/ UR - https://doi.org/10.2196/jmir.1732 UR - http://www.ncbi.nlm.nih.gov/pubmed/21550961 DO - 10.2196/jmir.1732 ID - info:doi/10.2196/jmir.1732 ER -