CAJ | 학술논문

目的：评估胸部CT平扫对贫血诊断的准确性，分析胸部CT平扫误诊贫血的原因。方法回顾性分析270例胸部CT诊断为贫血的患者，按照临床诊断标准分为贫血组；无贫血者为误诊组。所有病例均测量左心室血液及室间隔的CT值、血液中Hb的浓度、计算左心室血液与室间隔CT比值（CT比值），同时探讨误诊的原因。结果贫血组194例，胸部CT诊断贫血准确率71.9%，误诊组76例（28.1%）。贫血组：血液Hb浓度与左心室血液CT值、室间隔CT值、CT比值呈正相关（r=0.428，P＜0.001；r=0.171，P=0.017；r=0.340， P＜0.001）；误诊组：血液Hb浓度与左心室血液CT值、室间隔CT值、CT比值无相关性（r=0.194， P=0.093；r=0.208，P=0.071；r=0.073，P=0.531）；误诊原因分析与血液Hb浓度接近临界值、心脏搏动及各种伪影干扰诊断有关。结论胸部CT可以较为准确的诊断贫血，而左心室CT值减低与贫血的相关性更好，但由于受到贫血程度、诊断经验、心脏搏动等伪影影响，造成一定比例的误诊。
목적：평고흉부CT평소대빈혈진단적준학성，분석흉부CT평소오진빈혈적원인。방법회고성분석270례흉부CT진단위빈혈적환자，안조림상진단표준분위빈혈조；무빈혈자위오진조。소유병례균측량좌심실혈액급실간격적CT치、혈액중Hb적농도、계산좌심실혈액여실간격CT비치（CT비치），동시탐토오진적원인。결과빈혈조194례，흉부CT진단빈혈준학솔71.9%，오진조76례（28.1%）。빈혈조：혈액Hb농도여좌심실혈액CT치、실간격CT치、CT비치정정상관（r=0.428，P＜0.001；r=0.171，P=0.017；r=0.340， P＜0.001）；오진조：혈액Hb농도여좌심실혈액CT치、실간격CT치、CT비치무상관성（r=0.194， P=0.093；r=0.208，P=0.071；r=0.073，P=0.531）；오진원인분석여혈액Hb농도접근림계치、심장박동급각충위영간우진단유관。결론흉부CT가이교위준학적진단빈혈，이좌심실CT치감저여빈혈적상관성경호，단유우수도빈혈정도、진단경험、심장박동등위영영향，조성일정비례적오진。
ObjectiveThe purpose of this study was to prospectively evaluate the diagnostic accuracy of anemia by Chest computed tomography and the causes of erroneous diagnosis of anemia.MethodsTwo hundred and seventy cases with anemia sign by Chest computed tomography were collected. According to the clinical diagnostic criteria of anemia, data of them were divided into anemia group and misdiagnosis group. All cases were measured CT value including left ventricular blood and the interventricular septum and hemoglobin concentration in the blood. The left ventricular blood ratio (CT) and interventricular septum CT ratio was calculated. In addition, the misdiagnosis causes were analyzed.ResultsOf which 194 cases with anemia group were clinically confirmed. The diagnostic accuracy of anemia by Chest computed tomography was 71.9%. Seventy-six cases (28.1%) were misdiagnosed. In anemia group, there were positive correlations between hemoglobin concentration and left ventricular blood CT value and the interventricular septum CT value and CT ratio (r=0.428, P<0.001; r=0.66,P=0.01; r=0.171,P=0.017; r=0.340,P<0.001), respectively. However, there were not positive correlations between hemoglobin concentration and left ventricular blood CT value and the interventricular septum CT value and CT ratio(r=0.194,P=0.093; r=0.208,P=0.071; r=0.073,P=0.531)in misdiagnosis group. Nearly normal hemoglobin concentration, effects of heart beat and interference of artifacts were the causes of erroneous diagnosis. ConclusionChest computed tomography can be more accurate diagnosis of anemia. The attenuation of left ventricular cavity was correlated with the presence of anemia. However, some factors such as the degree of anemia, diagnostic experience and artifacts could lead to a certain proportion of misdiagnosis.