Katsouda Emmanouela, Mystakidou Kyriaki, Rapti Aggeliki, Argentos Stelios, Kelekis Nikolaos L, Mastorakou Renata, Anagnostopoulou Ourania, Kelekis Dimitrios A
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, 27 Korinthias Str., 115 26 Athens, Greece.
In Vivo. 2005 Sep-Oct;19(5):873-8.
To prospectively evaluate the diagnostic accuracy of spiral computed tomography (CT) versus ventilation/perfusion (V/Q) scanning in the examination of patients clinically suspected of having pulmonary embolism (PE).
Sixty-three patients, presenting to the emergency department and departments of radiology and nuclear medicine of a large hospital, highly suspected of having PE, underwent sequential imaging testing with V/Q scanning and contrast-enhanced spiral CT, in addition to other clinical and laboratory tests.
PE was diagnosed in 42 (66.7%) of the 63 patients. Thirty-nine of these 42 patients had positive findings in their CT scans, while 18 of the remaining 21 patients without PE had negative findings in their spiral CT [sensitivity, 92.9%, specificity, 85.7% Positive Predictive Value (PPV), 92.9%, Negative Predictive Value (NPV), 85.7%]. V/Q scans showed high-probability of PE in 24 of the 42 patients with PE and were negative in 9 of the remaining 21 patients without PE (sensitivity, 571%, specificity, 42.9%, PPV, 66.7%, NPV, 33.3%). There were statistically significant differences in specificity and sensitivity favoring spiral CT among men and women patients or patients > 50 years old. Fifty-four patients (85.7%) rated their satisfaction towards spiral CT as 'good' or 'very good', whereas the respective rate for V/Q scanning was only 14.3%.
Spiral CT has an excellent sensitivity, specificity, PPV and NPV for the diagnosis of PE and it could be used as the first-line imaging modality in patients suspected of PE.
前瞻性评估螺旋计算机断层扫描（CT）与通气/灌注（V/Q）扫描对临床疑似肺栓塞（PE）患者检查的诊断准确性。
63例患者前往一家大型医院的急诊科、放射科和核医学科就诊，高度怀疑患有PE，除进行其他临床和实验室检查外，还依次接受了V/Q扫描和对比增强螺旋CT成像检查。
63例患者中有42例（66.7%）被诊断为PE。这42例患者中39例CT扫描结果为阳性，其余21例未患PE的患者中有18例螺旋CT检查结果为阴性[灵敏度为92.9%，特异度为85.7%，阳性预测值（PPV）为92.9%，阴性预测值（NPV）为85.7%]。V/Q扫描显示，42例PE患者中有24例PE可能性高，其余21例未患PE的患者中有9例扫描结果为阴性（灵敏度为57.1%，特异度为42.9%，PPV为66.7%，NPV为33.3%）。在男性和女性患者或年龄大于50岁的患者中，螺旋CT在特异度和灵敏度方面具有统计学显著差异。54例患者（85.7%）对螺旋CT的满意度评价为“好”或“非常好”，而V/Q扫描的相应比例仅为14.3%。
螺旋CT对PE诊断具有出色的灵敏度、特异度、PPV和NPV，可作为疑似PE患者的一线成像检查方法。
