独立的前后对比扩散模式不足以区分腰部外周和外周扩散:前性研究
Afrin Sagir1,2, Thomas T Simopoulos2, Jyotsna V Nagda2
1Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Penn Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Suite 680 Dulles, Philadelphia, PA, 19104, USA.
Interventional pain medicine
|September 2, 2025
概括
仅靠前后视图 (AP) 就不足以区分皮质外注与非皮质外注在腰部皮质外注时的对比扩散. 反侧斜视图 (CLO) 显著提高了医生之间的准确性和一致性.
科学领域:
- 治疗疼痛
- 放射学
- 麻醉学
背景情况:
- 关于单独前后视图 (AP) 在区分外周和非外周对比传播的有效性存在争议.
- 精确的对比分布可视化对于外周术的安全性和有效性至关重要.
研究的目的:
- 评估和比较AP和Contralateral Oblique (CLO) 视图的诊断准确性,以区分外周和非外周对比传播模式.
- 在解释对比度扩散时评估每个视图的观察者之间的共识.
主要方法:
- 一项涉及接受腰部外周类固醇注射的患者的研究.
- 在注射后注入小量的对比剂 (0. 5 - 1毫升)
- 获取AP,CLO和侧面图像,与非皮质扩散的AP和CLO图像与真正的皮质扩散图像混合,由10名干预性疼痛医生进行审查.
主要成果:
- 单独AP视图的准确性很低 (51%为外周注射,64%为非外周注射),观察者之间的一致性很小 (科恩卡帕 = 0.15).
- 单独CLO视图显示了高准确率 (99%用于外围注射,96- 99%用于非外围注射),观察者之间有很大的一致性 (科恩卡帕=0. 95).
结论:
- 一个独立的AP视图不足以可靠地区分外周和非外周对比传播.
- 反侧斜视 (CLO) 视图对于精确识别外围膜对比度扩散至关重要,应继续使用.
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