呼吸透气扫描用于诊断肺栓塞:胸部X射线是否重要?
Thomas J Conrad1,2, Han X Lau1, Stephanie T Yerkovich3,4
1Internal Medicine Services, The Prince Charles Hospital, Metro North Health, Brisbane.
异常的胸部X射线 (CXR) 不妨碍对通风 perfusion (V / Q) 扫描的解释,以诊断肺栓塞 (PE). 对于PE的管理决策不受CXR结果的影响,这表明当前的指南可能需要修订.
科学领域:
- 放射学 放射学是一门学科.
- 诊断成像 诊断成像 诊断成像
- 肺部医学 肺部医学
背景情况:
- 使用SPECT进行的通风 perfusion (V/Q) 扫描是肺栓塞 (PE) 诊断的标准.
- 异常的胸部X射线 (CXR) 通常被认为是V/Q扫描解释的禁忌.
研究的目的:
- 评估异常CXR发现对V/Q扫描解释的影响.
- 评估CXR结果对疑似急性PE的管理的影响.
主要方法:
- 对340名患者进行疑似PE的V/Q扫描的回顾性分析 (2016年3月-2022年).
- 报告的CXR被分类为正常或异常.
- 收集了V/Q扫描结果和后续管理 (抗凝药,进一步调查) 的数据.
主要成果:
- 对于阳性和阴性V/Q扫描,正常和异常CXR组之间的抗凝血启动或进一步调查没有显著差异.
- 不管CXR状态如何,阳性V/Q扫描的抗凝率很高 (98.3%对100%).
- 不确定的V / Q扫描结果很少 (9例) 在CXR组中进行类似的管理.
结论:
- 当与SPECT相结合时,异常的CXR不会影响V/Q扫描解释PE诊断的可靠性.
- 在V/Q扫描之前推正常CXR的临床指南应该重新考虑,除非临床上有指示.
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