在对比增强CT检查之前,门诊脏功能查
Yunseo Lee1, Inpyeong Hwang1, Yeon Jin Cho1
1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Journal of Korean medical science
|October 8, 2024
概括
在对比度增强CT之前查功能至关重要. 目前的ACR和ESUR指南有效识别需要功能测试的患者,最大限度地降低对比引起的急性损伤的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 对比剂诱导的急性损伤 (CI-AKI) 是含有的对比剂的风险,特别是在估计膜过率降低的患者 (eGFR < 30 mL/min/1.73 m2) 中.
- 美国放射学学院 (ACR) 和欧洲泌尿器官放射学学会 (ESUR) 的当前指导方针建议通过病史查功能,但它们在现实世界中的有效性尚未得到充分证实.
研究的目的:
- 评估ACR和ESUR指南在识别需要在对比增强计算机断层扫描 (CT) 之前评估功能的患者时的有效性.
- 为了确定低eGFR在门诊患者群体中患病率,在没有先前eGFR测量的情况下进行对比增强CT.
主要方法:
- 对2560名成人门诊患者进行了反差增强CT的回顾性分析,没有最近的eGFR数据.
- 在CT的当天,测量了eGFR. 根据ACR和ESUR查标准评估了病史.
- 分析了EGFR<30mL/min/1.73m2的患病率和查策略的表现.
主要成果:
- 1.1%的患者的EGFR<30mL/min/1.73m2,通常与痛风或病史有关.
- ACR和ESUR策略分别确定了16.9%和38.8%的患者,捕获了92.6%和96.3%的功能不全患者.
- 这两种查方法都显示出高负预测值,表明它们在排除显著功能障碍方面的有用性.
结论:
- 使用ACR和ESUR指导方针进行选择性功能查,在进行对比增强检查之前有效地识别CI-AKI风险患者.
- 这些策略显示出高灵敏度和负预测值,支持在临床实践中使用它们以确保患者安全.
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