在急诊室急性腹痛的成像请求:一个回顾性横截面研究
Esteban Vasquez1,2, Andrea Torres3, Belén Báez3
1Department of Imaging, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile. esteban.avc@gmail.com.
Emergency radiology
|September 16, 2025
概括
对急性腹痛进行适当的成像要求显著增加了诊断产量,特别是在CT和US. 老年也与在紧急成像中更好的诊断结果相关.
科学领域:
- 放射学和医学成像学 医学成像学
- 医疗保健服务研究 医疗服务研究
- 临床决策支持 临床决策支持
背景情况:
- 急性腹痛 (AAP) 是紧急成像的常见原因.
- 图像请求的适当性会影响诊断的准确性和资源的利用.
- 该ACR适当性标准提供了最佳成像选择的指导方针.
研究的目的:
- 评估AAP患者成像请求 (AIR) 的适当性与诊断产量之间的关联.
- 通过多变量模型在AAP成像中识别诊断产量的预测因素.
主要方法:
- 对圣地亚哥的AAP进行189项成像研究 (US,CT,MRI) 的回顾性横截面研究 (2023年).
- 使用ACR适当性标准分类的AIR;放射学报告被分类为确认或正常.
- 多变量逻辑回归分析了诊断产量的预测因素,包括AIR,模式和年龄之间的相互作用.
主要成果:
- 57.7%的成像请求是适当的,与不适当的请求 (41.3%) 相比,诊断收益率更高 (84.4%).
- 不适当性显著降低了US和CT的诊断产量,但不是MRI.
- 高龄独立地与更高的诊断产量相关;表胃疼痛和胃肠炎与过度使用有关.
结论:
- 遵守ACR标准显著改善了AAP的诊断产量,特别是CT和US.
- 年龄和当地流行病学影响成像模式的性能.
- 这些发现支持决策支持工具和进一步的研究,以优化紧急成像策略.
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