检测急性肺血栓栓塞的胸部非对照式计算机断层扫描:一个单中心的回顾性研究
Runcai Guo1, Mei Deng2, Linfeng Xi3
1Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, P.R. China.
Experimental and therapeutic medicine
|June 14, 2024
概括
胸部非对比CT (NC-CT) 在诊断急性肺栓塞 (APE) 中不能替代CT肺血管造影 (CTPA). 然而,NC-CT上的超密度光标志对中央APE具有很高的特异性,在某些情况下可能避免CTPA.
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:
- 急性肺栓塞 (APE) 诊断严重依赖于计算机断层扫描肺血管造影 (CTPA).
- 无对照CT (NC-CT) 是广泛可用的,但其在APE检测中的作用不那么明确.
- 识别NC-CT的成像特征可以完善诊断途径.
研究的目的:
- 为了全面评估急性肺栓塞 (APE) 胸部NC-CT的诊断价值.
- 评估特定的NC-CT成像特征,包括超密度光线标志和外围形不透明度.
- 为了比较APE和无APE患者之间的这些发现的减弱值.
主要方法:
- 根据临床诊断对273名患者的回顾性分析,根据临床诊断分为APE (n=110) 和非APE (n=163) 组.
- 评价胸部NC-CT对高密度光线标志和外围形不透明性的评估.
- 两组之间的外围形不透明度的平均衰减值的比较.
- 对年龄调整的D-二分体结果与CTPA发现相关的分析.
主要成果:
- 超密度光线标志对APE检测具有很高的特异性 (97.6%),特别是对于中央APE (57.1%的灵敏度).
- 在APE患者中,外围形不透明度的衰减值明显较低 (P<0.001),表明APE存在.
- 胸部NC-CT单独不足以确定APE诊断,但具体的发现可以指导进一步的调查.
- 经年龄调整的D-二分体在排除APE时表现出更高的特异性.
结论:
- 胸部NC-CT不是CTPA的替代品,用于诊断APE.
- 在NC-CT上的超密度光线标志对中央APE具有高度特异性,在与升高的D-二次体相结合时,可能避免需要CTPA.
- 在NC-CT上具有较低衰减的外围形不透明性,值得CTPA确认.
- 根据年龄调整的D-二分体对于排除APE有价值.
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