Costantino Thomas G, Bruno Eric C, Handly Neal, Dean Anthony J
Drexel University College of Medicine, Department of Emergency Medicine, Philadelphia, Pennsylvania 19140, USA.
J Emerg Med. 2005 Nov;29(4):455-60. doi: 10.1016/j.jemermed.2005.02.016.
This study assesses the accuracy of Emergency Medicine (EM) residents in detecting the size and presence of abdominal aortic aneurysms (AAAs) using EM ultrasound (EUS) compared to radiology measurement (RAD) by computed tomography (CT) scan, magnetic resonance imaging (MRI), angiography, or operative findings. There were 238 aortic EUS performed from 1999-2000; 36 were positive for AAA. The EUS finding of "AAA" had a sensitivity of 0.94 (0.86-1.0 95% confidence interval [CI]) and specificity of 1 (0.98-1.0 95% CI). Mean aortic diameter among patients with AAA identified by EUS was 5.43+/-1.95 cm and by RAD was 5.35+/-1.83 cm. The mean absolute difference between EUS and RAD diameters was 4.4 mm (95% CI 3.7-5.5 mm). Regression of EUS on RAD diameters is strongly correlated, with R(2)=0.92. EM residents with appropriate training can accurately determine the presence of AAA as well as the maximal aortic diameter.
本研究评估了急诊医学（EM）住院医师使用急诊超声（EUS）检测腹主动脉瘤（AAA）大小及有无的准确性，并与计算机断层扫描（CT）、磁共振成像（MRI）、血管造影或手术所见的放射学测量（RAD）结果进行比较。1999年至2000年共进行了238次主动脉EUS检查；其中36次AAA检查呈阳性。EUS检查结果为“AAA”的敏感度为0.94（0.86 - 1.0，95%置信区间[CI]），特异度为1（0.98 - 1.0，95%CI）。经EUS检查确诊为AAA的患者，其主动脉平均直径为5.43±1.95 cm；经RAD检查确诊的患者，其主动脉平均直径为5.35±1.83 cm。EUS与RAD测量的主动脉直径平均绝对差值为4.4 mm（95%CI 3.7 - 5.5 mm）。EUS测量直径与RAD测量直径的回归分析相关性很强，R² = 0.92。接受过适当培训的EM住院医师能够准确判断AAA的有无以及主动脉最大直径。
