优化急诊室对肺栓塞的成像利用:一项关于IV对比率配给对IV对比率配给的影响的研究
Francisco Delgado1, Farid Hajibonabi1, Jada Hislop1
1Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Clinical imaging
|January 25, 2024
概括
一个对比度减轻方案显著降低了急诊室的肺栓塞 (PE) 成像,从CTPA转向VQ扫描,而不会影响诊断准确度. 需要进一步的研究来优化PE诊断策略.
科学领域:
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
- 医疗成像医学成像
背景情况:
- 肺栓塞 (PE) 诊断在很大程度上依赖于成像方式,如CT肺血管造影 (CTPA) 和通风 perfusion (VQ) 扫描.
- 全球缺少含的对比剂使得需要在医疗机构实施对比减轻协议.
研究的目的:
- 评估对比度减轻协议对疑似肺栓塞 (PE) 在急诊室 (ED) 的成像利用的影响.
主要方法:
- 对经过CTPA或VQ扫描的疑似PEED患者的医疗记录进行了回顾性分析.
- 数据是在对照期和试验期收集的,在此期间,由于对比度不足,对比度缓解协议是活跃的.
- 在两个时期之间比较了成像利用率,扫描类型 (CTPA与VQ),阳性率和时间指标.
主要成果:
- 与对照期 (6.54%) 相比,对比减轻协议期间显示PE的整体成像率显著降低 (4.16%).
- 在协议实施期间,CTPA利用率下降了47.73%,而VQ扫描使用率增加了775.00%.
- 尽管成像模式的使用方式发生了变化,但PE阳性率在两个时期之间仍然相似,ED停留时间和图像获取时间没有显著差异.
结论:
- 实施的对比度减轻协议有效地减少了CTPA在ED中用于PE诊断的使用,增加了VQ扫描的使用.
- 该方案保持了诊断的准确性,正如类似的阳性率所证明的那样,并且没有对患者的吞吐量产生负面影响.
- 关于不必要的成像和低阳性率的持续担忧突显出需要继续研究以改进PE诊断算法和成像策略.
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