中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2014年
4期
301-304
,共4页
陈聪霞%姚稚明%郭悦%于治国%刘秀芹
陳聰霞%姚稚明%郭悅%于治國%劉秀芹
진총하%요치명%곽열%우치국%류수근
肺栓塞%放射性核素显像%锝%MAA
肺栓塞%放射性覈素顯像%锝%MAA
폐전새%방사성핵소현상%득%MAA
Plumonary embolism%Radionuclide imaging%Technetium%MAA
目的 通过与CT肺动脉血管造影(CTPA)比较,探讨肺V/Q显像诊断老年急性肺栓塞的价值.方法 回顾性分析2008年至2010年44例年龄≥60岁的临床疑诊急性肺栓塞患者V/Q显像、CTPA及临床资料,其中男26例,女18例;平均年龄73.50岁.V/Q显像分别以肺栓塞诊断前瞻性研究Ⅱ(PIOPEDⅡ)诊断标准及急性肺栓塞诊断前瞻性研究(PISA-PED)诊断标准作出诊断.以出院诊断为“最终诊断”,分别计算PIOPEDⅡ诊断标准、PISA-PED诊断标准、CTPA及临床Wills评分诊断结果的灵敏度、特异性及准确性.采用x2检验及Fisher确切概率法比较不同诊断标准结果间的差异,采用Kappa分析比较PIOPEDⅡ诊断标准及PISA-PED诊断标准间的一致性.结果 PIOPEDⅡ诊断标准、PISA-PED诊断标准、CTPA及临床Wills评分诊断肺栓塞的灵敏度分别为70.00％ (14/20)、84.62％ (22/26)、65.22％(15/23)和23.08％(3/13),除Wills评分外,余三者差异均无统计学意义(x2=0.069～1.545,均P＞O.05);四者特异性分别为80.00％(12/15)、61.11％(11/18)、93.75％(15/16)和9/10,CTPA最高(P＜0.05);四者准确性分别为74.29％(26/35)、75.00％ (33/44)、76.92％(30/39)和52.17％(12/23),除Wills评分外,差异均无统计学意义(r=0.005～0.070,均P＞0.05).V/Q显像PIOPEDⅡ诊断标准及PISA-PED诊断标准的诊断符合率为77.14％(27/35),Kappa=0.547,P＜0.05.结论 V/Q显像和CTPA诊断老年急性肺栓塞的总体准确性相当.
目的 通過與CT肺動脈血管造影(CTPA)比較,探討肺V/Q顯像診斷老年急性肺栓塞的價值.方法 迴顧性分析2008年至2010年44例年齡≥60歲的臨床疑診急性肺栓塞患者V/Q顯像、CTPA及臨床資料,其中男26例,女18例;平均年齡73.50歲.V/Q顯像分彆以肺栓塞診斷前瞻性研究Ⅱ(PIOPEDⅡ)診斷標準及急性肺栓塞診斷前瞻性研究(PISA-PED)診斷標準作齣診斷.以齣院診斷為“最終診斷”,分彆計算PIOPEDⅡ診斷標準、PISA-PED診斷標準、CTPA及臨床Wills評分診斷結果的靈敏度、特異性及準確性.採用x2檢驗及Fisher確切概率法比較不同診斷標準結果間的差異,採用Kappa分析比較PIOPEDⅡ診斷標準及PISA-PED診斷標準間的一緻性.結果 PIOPEDⅡ診斷標準、PISA-PED診斷標準、CTPA及臨床Wills評分診斷肺栓塞的靈敏度分彆為70.00％ (14/20)、84.62％ (22/26)、65.22％(15/23)和23.08％(3/13),除Wills評分外,餘三者差異均無統計學意義(x2=0.069～1.545,均P＞O.05);四者特異性分彆為80.00％(12/15)、61.11％(11/18)、93.75％(15/16)和9/10,CTPA最高(P＜0.05);四者準確性分彆為74.29％(26/35)、75.00％ (33/44)、76.92％(30/39)和52.17％(12/23),除Wills評分外,差異均無統計學意義(r=0.005～0.070,均P＞0.05).V/Q顯像PIOPEDⅡ診斷標準及PISA-PED診斷標準的診斷符閤率為77.14％(27/35),Kappa=0.547,P＜0.05.結論 V/Q顯像和CTPA診斷老年急性肺栓塞的總體準確性相噹.
목적 통과여CT폐동맥혈관조영(CTPA)비교,탐토폐V/Q현상진단노년급성폐전새적개치.방법 회고성분석2008년지2010년44례년령≥60세적림상의진급성폐전새환자V/Q현상、CTPA급림상자료,기중남26례,녀18례;평균년령73.50세.V/Q현상분별이폐전새진단전첨성연구Ⅱ(PIOPEDⅡ)진단표준급급성폐전새진단전첨성연구(PISA-PED)진단표준작출진단.이출원진단위“최종진단”,분별계산PIOPEDⅡ진단표준、PISA-PED진단표준、CTPA급림상Wills평분진단결과적령민도、특이성급준학성.채용x2검험급Fisher학절개솔법비교불동진단표준결과간적차이,채용Kappa분석비교PIOPEDⅡ진단표준급PISA-PED진단표준간적일치성.결과 PIOPEDⅡ진단표준、PISA-PED진단표준、CTPA급림상Wills평분진단폐전새적령민도분별위70.00％ (14/20)、84.62％ (22/26)、65.22％(15/23)화23.08％(3/13),제Wills평분외,여삼자차이균무통계학의의(x2=0.069～1.545,균P＞O.05);사자특이성분별위80.00％(12/15)、61.11％(11/18)、93.75％(15/16)화9/10,CTPA최고(P＜0.05);사자준학성분별위74.29％(26/35)、75.00％ (33/44)、76.92％(30/39)화52.17％(12/23),제Wills평분외,차이균무통계학의의(r=0.005～0.070,균P＞0.05).V/Q현상PIOPEDⅡ진단표준급PISA-PED진단표준적진단부합솔위77.14％(27/35),Kappa=0.547,P＜0.05.결론 V/Q현상화CTPA진단노년급성폐전새적총체준학성상당.
Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.
