怀孕期间急性尾炎的磁共振成像:临床分数可以预测何时需要成像吗?
Noam Kahana1, Elad Boaz1, Mariya Neymark2
1Department of General Surgery, Shaare Zedek medical center, the Hebrew University School of Medicine, Jerusalem, Israel.
概括
怀孕患者怀疑尾炎的临床评分系统显示敏感度低. 需要进一步的研究,以优化磁共振成像 (MRI) 的使用,以诊断怀孕期间的尾炎.
科学领域:
- 产科和妇科 产科和妇科
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
背景情况:
- 在怀孕期间诊断急性尾炎 (AA) 是一个挑战.
- 像磁共振成像 (MRI) 这样的先进成像可能有助于诊断.
- 怀疑AA的孕妇患者的先进成像的最佳时间和适用性尚不清楚.
研究的目的:
- 评估临床评分系统的敏感性和特异性 (阿尔瓦拉多和尾炎炎性反应 (AIR) 评分) 与孕妇急性尾炎的MRI发现相比.
- 在这个人群中,在MRI上确定与AA相关的临床因素.
主要方法:
- 怀孕患者怀疑AA接受MRI的回顾性队列研究 (2019-2021年) 在两个三级中心.
- 收集了患者的人口统计数据,平价,妊娠期,症状和症状.
- 计算了阿尔瓦拉多和AIR分数,并将它们与临床和MRI发现相关联.
主要成果:
- 在255名 (13%) 怀孕患者中,有33名怀孕患者的MRI检测结果为AA.
- 第二/第三季度,疼痛迁移,吐和RLQ疼痛与MRI上的AA相关.
- 阿尔瓦拉多得分≥5:灵敏度为84.8%,特异性为36.6%. AIR评分≥5:灵敏度为78.8%,特异性为41.5%. 这是一个非常好的评分.
结论:
- 临床评分系统可能有助于识别怀孕患者需要MRI疑似尾炎.
- 当前评分系统的低灵敏度表明需要改进.
- 需要进一步的研究,以优化MRI利用在怀孕期间诊断尾炎.
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