患有22q11删除综合征的患者进行手术前成像,这些患者正在接受喉外科手术
Kelsey A Duckett1, Nicolas S Poupore1, William W Carroll1
1Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
The Laryngoscope
|December 5, 2023
概括
建议在患有22q11删除综合征 (22qDS) 的儿童手术时进行手术前成像,尽管它很少改变手术计划. 需要进一步的研究来证实其在预防内动脉 (ICA) 损伤方面的益处.
科学领域:
- 医学成像医学成像
- 儿科外科手术 儿科外科手术
- 遗传学 遗传学 是一个
背景情况:
- 在患有22q11删除综合征 (22qDS) 的儿童中,喉功能障碍 (VPD) 手术很常见.
- 内动脉 (ICA) 中介化在VPD手术期间是一个潜在的风险.
- 术前成像通常被认为是评估ICA媒介化的风险.
研究的目的:
- 评估手术前成像在识别内动脉 (ICA) 中介化的22qDS接受VPD手术的儿童的实用性.
- 确定手术前成像研究结果对手术规划和结果的影响.
主要方法:
- 根据PRISMA指南进行了系统审查.
- 研究包括22qDS的儿童,他们进行了手术前成像 (MRA或CTA) 以检测ICA异常.
- 用比例的元分析来分析ICA介质化和手术修饰的比率.
主要成果:
- 分析了11项涉及398名患者的研究.
- 在47.1%的成像患者中发现了ICA媒介,其中46.3%被认为是高风险的.
- 由于媒介化的ICAs,手术计划在19.4%的病例中被修改.
- 鼻镜检测中介化的真阳性率为53.9%,假阳性率为16.2%.
- 81.8%的研究建议进行例行术前成像,但没有报告术后ICA损伤.
结论:
- 虽然经常建议在接受VPD手术的22qDS患者中进行ICA媒介化的例行术前成像,但在少数情况下,它会导致手术修改.
- 报告的ICA损伤率很低,这表明需要进一步调查常规手术前成像的实际益处.
- 需要进行比较性研究,以评估患有和没有手术前成像的儿童的结果.
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