胸部X射线扫描对于传染性或炎症性肺病的预测能力
Nate C Hull1, Paul G Thacker1, Richard Paul Boesch2
1Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
胸部X射线 (CXR) 不是可靠的排除儿科肺炎或感染,尽管廉价和低辐射. 正常的CXR在患有慢性呼吸道症状的儿童中排除这些疾病的能力有限.
科学领域:
- 儿科肺病学 儿科肺病学
- 诊断成像 诊断成像 诊断成像
- 传染性疾病 传染性疾病
背景情况:
- 慢性咳,复发性感染和消化障碍在儿童中很常见.
- 这些症状往往与严重的炎症性肺病无关.
- 支气管支气管洗 (BAL) 是最终的,但侵入性和昂贵;胸部X射线 (CXR) 是可获得的替代方案.
研究的目的:
- 评估胸部X射线 (CXR) 在预测或排除儿科患者感染性或炎症性肺病的准确性.
- 与BAL发现相比,确定CXR的灵敏度,特异性,正预测值 (PPV) 和负预测值 (NPV).
主要方法:
- 在CXR后两周内,对儿科患者进行灵活支气管镜检查 (FFB) 并使用BAL进行回顾性队列研究.
- 两位高级儿科放射科医生对CXR图像进行盲目审查,以发现炎症发现.
- 对CXR与BAL结果的诊断准确度指标的计算.
主要成果:
- 在344名受试者中,77%的CXR发现为阳性.
- 对BAL炎症/感染的CXR敏感性很高 (84.7-90.9%).
- 对于炎症或感染,CXR的特异性和PPV较低,NPV在65.0%至87.5%之间.
结论:
- 胸部X射线 (CXR) 对于检测儿童肺炎或感染的迹象非常有价值.
- 然而,正常的CXR在排除活性炎症或传染性肺病方面具有有限的效用.
- 在患有有关呼吸道症状的儿科患者中,应谨慎解释CXR.
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