在诊断急性尾炎中CT协议的比较:对诊断性能和操作效率的系统审查
Fahim Kanani1,2,3, Nuha Riyad2,4, Osama Ewidat2,4
1Department of Surgery B, Wolfson Medical Center, Holon, Israel.
The American surgeon
|February 5, 2026
概括
对于诊断成年人的尾炎,非对比或静脉 (IV) 对比计算机断层扫描 (CT) 扫描提供与口服对比方法相似的准确性. 消除口腔对比可以显著提高急诊室工作流程的效率.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 胃肠道成像技术 胃肠道成像技术
背景情况:
- 计算机断层扫描 (CT) 是诊断成年人急性尾炎的主要成像工具.
- 人们对CT对比方案的选择进行了讨论,影响了准确性,效率和安全性.
研究的目的:
- 系统地比较成年人急性尾炎的各种CT对比方案的诊断准确性和操作效率.
- 评估的方案包括口服对比剂,静脉注射 (IV) 对比剂,口服+IV对比剂组合和非对比剂CT.
主要方法:
- 一项系统性审查和对比CT对比方案用于尾炎诊断的研究的元分析.
- 在MEDLINE,Embase,Cochrane图书馆和科学网络上搜索到2025年4月.
- 从涉及5033名患者的17项研究中提取了诊断 (敏感性,特异性) 和操作 (ED停留时间) 结果.
主要成果:
- 非对比CT:灵敏度为82.4-90.5%,特异性为75-100%.
- 口服对比度:73.5%的灵敏度,80%的特异性.
- 只有IV的对比度:77.8-100%的灵敏度,87-100%的特异性.
- 结合口服+静脉对比:灵敏度为89.4-100%,特异性为54.5-98.5%.
- 消除口服对比可以将ED停留时间减少29-91分钟,而不会影响准确度.
结论:
- 只有静脉注射 (IV) 或没有对比度的CT协议提供了与尾炎的口服对比度方法相比的诊断准确性.
- 这些协议显著提高了紧急部门的工作流程的效率.
- 口腔对比剂可能只适用于特定的患者群体,例如瘤患者或之前经历过腹部手术的患者.
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