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仰卧位和俯卧位下胺碘酮所致肺毒性的检测:高分辨率计算机断层扫描研究

Detection of amiodarone-induced pulmonary toxicity in supine and prone positions: high-resolution computed tomography study.

作者信息

Oyama Noriko, Oyama Naotsugu, Yokoshiki Hisashi, Kamishima Tamotsu, Nambu Toshikazu, Tsutsui Hiroyuki, Miyasaka Kazuo

机构信息

Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

出版信息

Circ J. 2005 Apr;69(4):466-70. doi: 10.1253/circj.69.466.

Abstract

BACKGROUND

The aim of the present study was to describe the effectiveness and feasibility of high-resolution computed tomography (HRCT) in patients in supine and prone positions to detect amiodarone-induced pulmonary toxicity (APT). With regard to the possible differential diagnosis, our second goal was to emphasize the clinical value of HRCT with the patients in supine and prone positions compared with other paraclinical tests.

METHODS AND RESULTS

Thoracic HRCT taken in both positions for 23 patients who were administrated amiodarone were prospectively evaluated in the current study. High-resolution computed tomography scans obtained with the patient in a prone position were helpful in differentiating dependent opacity from lung disease in 11 out of 23 patients. In another 4 patients, HRCT scans obtained with the patient in a prone position were useful in confirming the presence of subtle ground-glass opacities, considered as APT. Combination of HRCT in supine and prone positions provided a more reproducible method for evaluating the global extent of APT than other paraclinical tests.

CONCLUSIONS

High-resolution computed tomography used in prone positions as well as a supine position could be an effective technique for reducing false-positive results in detection of APT and preventing the clinically serious pulmonary adverse effects by amiodanone.

摘要

背景

本研究的目的是描述高分辨率计算机断层扫描(HRCT)在仰卧位和俯卧位患者中检测胺碘酮所致肺毒性(APT)的有效性和可行性。关于可能的鉴别诊断,我们的第二个目标是强调与其他临床检查相比,仰卧位和俯卧位HRCT对患者的临床价值。

方法与结果

本研究对23例接受胺碘酮治疗的患者在两个体位下进行的胸部HRCT进行了前瞻性评估。在23例患者中,有11例患者俯卧位时获得的高分辨率计算机断层扫描有助于鉴别肺部疾病与依赖部位的实变影。在另外4例患者中,俯卧位时获得的HRCT扫描有助于确认被视为APT的细微磨玻璃影的存在。与其他临床检查相比,仰卧位和俯卧位HRCT联合应用为评估APT的整体范围提供了一种更可重复的方法。

结论

在俯卧位和仰卧位使用高分辨率计算机断层扫描可能是一种有效的技术,可减少APT检测中的假阳性结果,并预防胺碘酮引起的临床上严重的肺部不良反应。

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