Currie Geoffrey M, Towers Philip A, Wheat Janelle M
School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, Australia.
J Nucl Med Technol. 2007 Jun;35(2):105-11. doi: 10.2967/jnmt.106.037044. Epub 2007 May 11.
Does subtraction scintigraphy improve the diagnostic utility of scintigraphic evaluation in acute lower gastrointestinal hemorrhage?
This research was a retrospective clinical study using a repeat-measures design of randomized control and experimental groups. A single patient dataset provided both the control group (conventional scintigraphy) and the experimental group (conventional and subtraction techniques). Forty-nine raw (99m)Tc-red blood cell studies were randomized and interpreted by 4 independent physicians as conventional scintigraphy data only (round 1). The conventional scintigraphy studies were combined with subtraction images and randomized for reinterpretation (round 2).
Although there was a decrease in the mean, no statistically significant difference was noted between the mean time to bleed detection between interpretive rounds 1 and 2 (P = 0.524). The addition of subtraction scintigraphy to the interpretation process changed the outcome from "probably present" to "absent" for 14% of patients and from "equivocal" to "absent" for another 12%, and this change had a marked effect on the false-positive rate. The false-positive rate decreased from 9.6% in round 1 to 3.6% in round 2. Receiver operator characteristic analysis showed that combining conventional scintigraphy with subtraction scintigraphy improved test performance.
False-positive studies can be reduced by using subtraction scintigraphy in conjunction with conventional scintigraphy in the interpretive process.
减法闪烁扫描术能否提高急性下消化道出血闪烁扫描评估的诊断效用？
本研究为一项回顾性临床研究，采用随机对照和实验组的重复测量设计。单个患者数据集同时提供了对照组（传统闪烁扫描术）和实验组（传统及减法技术）。49例原始的（99m）锝红细胞研究被随机分组，并由4名独立医生仅作为传统闪烁扫描数据进行解读（第1轮）。将传统闪烁扫描研究与减法图像相结合并随机进行重新解读（第2轮）。
尽管均值有所下降，但第1轮和第2轮解读之间在检测出血的平均时间上未观察到统计学上的显著差异（P = 0.524）。在解读过程中加入减法闪烁扫描术，使14%的患者结果从“可能存在”变为“不存在”，另有12%的患者结果从“不明确”变为“不存在”，这种变化对假阳性率有显著影响。假阳性率从第1轮的9.6%降至第2轮的3.6%。受试者操作特征分析表明，将传统闪烁扫描术与减法闪烁扫描术相结合可提高检测性能。
在解读过程中，将减法闪烁扫描术与传统闪烁扫描术结合使用可减少假阳性研究。
