摘要
目的比较分析各种影像学检查对肺栓塞(PE)诊断的临床价值。方法63例疑有PE的患者分别进行了X线胸片、心脏超声检查、CT肺动脉造影(CTPA)、核素肺通气/灌注(V/P)显像,其中部分患者进行了磁共振肺动脉成像(MRPA)、肺动脉造影(PGA)。分别评价各种影像学检查对PE诊断的临床价值。结果对PE诊断的灵敏度和特异性分别为:X线胸片43.48%和35.29%;心脏超声检查54.35%和76.47%;核素V/P显像95.65%和94.12%;CTPA95.45%和93.75%;MRPA87.10%和92.31%;PGA97.50%和100.00%。核素V/P显像、CTPA与PGA诊断肺栓塞灵敏度和特异性的差异无统计学意义(χ2分别=2.13、3.36,P均>0.05),而X线胸片、心超与PGA诊断肺栓塞灵敏度和特异性的差异有统计学意义(χ2分别=19.87、26.73,P均<0.05)。结论X线胸片、心脏超声检查可作为可疑病例的筛选检查;核素V/P显像和CTPA或MRPA基本上可取代PGA检查。
Objective To compare the clinical significances of different imaging examinations for diagnosis of pulmonary embolism （PE）. Methods Sixty three patients suspected to PE were examined respectively by different imaging examination such as chest X-ray, cardiac uhrasonograph, CTPA, and pulmonary V/P scintigraphy, some of which were also examined with MRPA and PGA. Clinical significances of different imaging examinations for PE diagnosis were evaluated. Results The sensitivity of chest X-ray, cardiac uhrasonograph, pulmonary V/P scintigraphy and CTPA, as well as MRPA and PGA were 43.48%, 54.35%, 95.65%, 95.45%, 87.10% and 97.50%, respectively. While the specificity of them were 35.29%, 76.47%, 94.12%, 93.75%, 92.31% and 100.00%, respectively. The sensitivity and specificity had no significant difference between pulmonary V/P scintigraphy, CTPA and PGA （X^2=2.13, 3.36,P〉0.05）. The sensitivity and specificity had significant difference between chest X-ray, cardiac uhrasonograph, and PGA （X^2=19.87, 26.73, P〈0.05）. Conclusion Chest X-ray and cardiac uhrasonograph can only be used as a screening examination. It is considered to replace PGA with pulmonary V/P scintigraphy and CTPA, or MRPA.
出处
《全科医学临床与教育》
2008年第6期475-477,共3页
Clinical Education of General Practice
关键词
肺栓塞
诊断
影像学
pulmonary embolism
diagnosis
radiology
