对评分系统和MRI用于诊断孕妇患者急性尾炎的比较分析
Eliahu Y Bekhor1, Olga Esepkina1, Tal Livne1
1Department of Surgery, Rabin Medical Center, Petah Tikva, Israel.
World journal of surgery
|March 13, 2025
概括
在孕妇患者中诊断急性尾炎 (AA) 是具有挑战性的. 磁共振成像 (MRI) 显示在怀孕期间AA诊断的临床评分系统比更高的准确性.
科学领域:
- 产科和妇科 产科和妇科
- 手术诊断 诊断 手术诊断
- 医疗成像医学成像
背景情况:
- 急性尾炎 (AA) 是怀孕中最常见的手术紧急情况.
- 现有的AA诊断评分系统在孕妇人群中缺乏完全的验证.
- 磁共振成像 (MRI) 越来越多地使用,需要精度评估.
研究的目的:
- 评估临床评分系统和MRI的诊断准确性,以检测孕妇的急性尾炎.
- 将Alvarado,Tzanakis,RIPASA和AIR评分系统的性能与MRI发现进行比较.
- 确定怀孕期间AA最可靠的诊断工具.
主要方法:
- 对180名怀孕患者的回顾性分析,这些患者接受了疑似AA的MRI (2013-2023年).
- 患者分为AA (n=28) 和对照组.
- 在各组之间比较Alvarado,Tzanakis,RIPASA,AIR得分和MRI发现.
主要成果:
- 大多数AA患者的临床评分为负 (例如,Alvarado 82%,AIR 43%).
- 临床评分显示了适度的正预测值 (PPVs) (12%-57%),但高负预测值 (NPVs) (80%-86%).
- 核磁共振扫描显示了较高的PPV (62%) 和优秀的NPV (96%) 对于AA诊断.
结论:
- 在怀孕期间诊断AA仍然很复杂,临床分数和成像之间存在显著的差距.
- 核磁共振是诊断孕妇急性尾炎的比临床评分系统更准确的工具.
- 临床评分的高NPV表明它们在排除AA方面的实用性,但MRI在确认方面优越.
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