喉的计算机断层成像,用于诊断声带功能障碍
Joo H Koh1,2, Laurence E Ruane1,3, Debra Phyland2
1Monash Lung Sleep Allergy & Immunology, Monash Health and University, Melbourne, Victoria, Australia.
NEJM evidence
|February 6, 2024
概括
低剂量的喉CT成像显示出诊断声带功能障碍/诱导性喉阻塞 (VCD/ILO) 的前景. 虽然特异性很高,但积极的预测值有所不同,这凸显了诊断这种类似喘的疾病时需要谨慎解释的必要性.
科学领域:
- 肺部病理学 肺部病理学
- 放射学 放射学是指放射学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 声带功能障碍/诱导性喉阻塞 (VCD/ILO) 呈现为喘息,经常模仿或同时发生严重的喘.
- 诊断通常依赖于间歇性喉腔镜检查,由于病情的偶发性质,这会带来挑战.
研究的目的:
- 评估低剂量动态计算机断层扫描 (CT) 喉成像的诊断准确性,作为用于VCD/ILO的喉腔镜的替代方案.
- 为了比较喉CT在诊断VCD/ILO的性能,在不同的程序设置中.
主要方法:
- 进行了两个病例系列:A系列 (n=31) 与同时进行喉腔镜和CT成像 (1小时内).
- 系列B (n=72) 采用分隔的喉腔镜和CT成像 (4-6周间隔).
- CT诊断是基于经过验证的声带缩小值,与喉腔镜检查结果相比较.
主要成果:
- 系列A显示CT灵敏度为53.8%,特异性为88.9%.
- 系列B显示CT敏感度提高了76.2%,特异性提高了93.3%.
- 两个系列的负预测值都超过了80%,而正预测值则有所不同 (A中的67.5%,B中的83%).
结论:
- 低剂量喉腔CT成像是VCD/ILO诊断的可行工具,特别有效地排除了这种情况 (高NPV).
- 观察到CT和喉腔镜之间的诊断一致性,尽管基于手术时间的积极预测值有所不同.
- 进一步的研究可能会改进CT协议,以提高VCD/ILO检测的积极预测准确性.
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