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脑电图扫描不能在急性尾炎中可靠地识别尾炎.
J G Mariadason1, P Bhattarai2, S Shah2
1Chief of Sub-Division of General Surgery, Metropolitan Hospital Center, Associate Professor of Surgery, New York Medical College at Metropolitan Hospital, 12th Floor, Metropolitan Hospital, 1901 First Ave, New York, NY, 10029, United States.
计算机断层扫描 (CT) 扫描对于检测尾炎是不可靠的,这可能会影响尾炎的非手术治疗. 这项研究发现CT扫描识别尾炎的准确性较低,这表明共享治疗决策.
科学领域:
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
背景情况:
- 非手术治疗尾炎 (NOMA) 对于没有并发症的病例是有效的.
- 尾炎与增加的并发症风险有关,使其成为NOMA的相对禁忌.
- 计算机断层扫描 (CT) 识别尾炎的准确性通常是假设的,但尚未确立.
研究的目的:
- 评估CT扫描在识别尾炎时的准确性.
- 将CT检测结果与病理样本进行比较.
- 为了为临床决策提供有关NOMA的信息.
主要方法:
- 对1552名尾切除术患者进行了术前CT扫描 (2001-2019) 的回顾性电子病历审查.
- 两名放射科医生重新解释了对尾炎存在的CT扫描.
- 将CT检测结果与在外科病理样本中发现的尾炎进行比较.
- 对正预测值 (PPV),负预测值 (NPV),灵敏度和特异性的计算.
主要成果:
- 在CT上尾炎的总体PPV为62% (A队列:69%,B队列:57%).
- 总的净净值为83% (A队列:80%,B队列:87%).
- 总体敏感度为55% (A队列:48%,B队列:66%),特异性为86% (A队列:91%,B队列:82%).
- 观察到放射科医生准确度的显著变化.
结论:
- 对尾炎的CT鉴定不可靠,这挑战了其作为NOMA的唯一决定因素的使用.
- 在CT上尾炎的存在不应排除患者接受抗生素治疗.
- 尾炎的CT发现应该是尾炎管理共享决策过程的一部分.
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