Görg C, Ozbatur H
Hämatologie, Universitätsklinik, Baldingerstrasse, 35043 Marburg.
Ultraschall Med. 2009 Aug;30(4):396-400. doi: 10.1055/s-0028-1109266. Epub 2009 Mar 20.
Transcutaneous ultrasound is not a common imaging procedure in patients with fever. The aim of this study is to demonstrate the diagnostic value of a complete standardized ultrasound examination of patients with fever.
From March 2003 to October 2003, we examined 200 patients with fever using ultrasound. We performed a standardized ultrasound examination including the collar, thoracal, cardial, abdominal regions, and small parts/soft tissue regions depending on clinical symptoms. We retrospective analyzed the patient history regarding fever (origin known vs. unknown) and the diagnostic value of ultrasound (no ultrasound diagnosis vs. ultrasound diagnosis).
At the time of inclusion in the study, the origin of fever was known in 124 of 200 patients (62 %) and unknown in 76 of 200 patients (38 %). Ultrasound did not result in a diagnosis in 86 of 200 patients (43 %). A pathological finding was detected in 114 of 200 cases (57 %) as the origin of the fever. New causes for fever were found in 24 of 200 patients (12 %) by means of ultrasound. The most common diagnoses (67 %) in this subgroup were abscesses and splenic infarcts.
In the clinical course of patients with fever, ultrasound is a diagnostic tool for the documentation and exclusion of medical findings. With this study we were able to show that ultrasound results in the correct diagnosis in one third of patients with fever of an unknown origin and may provide important additional information in patients with fever.
经皮超声检查在发热患者中并非常见的影像学检查方法。本研究的目的是证明对发热患者进行完整的标准化超声检查的诊断价值。
2003年3月至2003年10月,我们对200例发热患者进行了超声检查。根据临床症状,我们进行了标准化的超声检查,包括颈部、胸部、心脏、腹部区域以及小部位/软组织区域。我们回顾性分析了患者的发热病史(发热原因已知与未知)以及超声检查的诊断价值(未做出超声诊断与做出超声诊断)。
在纳入研究时,200例患者中有124例(62%)发热原因已知,76例(38%)发热原因未知。200例患者中有86例(43%)超声检查未得出诊断结果。200例病例中有114例(57%)检测到病理结果为发热原因。通过超声检查在200例患者中有24例(12%)发现了新的发热原因。该亚组中最常见的诊断(67%)为脓肿和脾梗死。
在发热患者的临床病程中,超声是记录和排除医学发现的诊断工具。通过本研究我们能够表明,超声检查能在三分之一不明原因发热患者中得出正确诊断,并且可能为发热患者提供重要的额外信息。