Department of Internal Medicine III, Friedrich Schiller University of Jena, Erlanger Allee 101, 07747 Jena, Germany.
Lung. 2010 Jan-Feb;188(1):43-50. doi: 10.1007/s00408-009-9195-x.
The aim of the study was to compare transthoracic sonography (TS) with multislice computed tomography (MSCT) in the detection of peripheral pulmonary embolism (PE). In addition, the study verified peripheral parenchymal findings visualized by TS and MSCT. A total of 33 patients (16 females, 17 males; mean age = 65.4 years) with symptoms of suspected PE were enrolled in the study. TS and MSCT were undertaken within 24 h of the beginning of clinical PE signs. Ten patients suffered from PE as visualized by MSCT. The sensitivity of TS for detecting PE was 70.0% and the specificity was 69.6%. Preferentially, PE and peripheral parenchymal findings were situated in the lower lobes. Oligemia was the main parenchymal alteration detected by MSCT. TS demonstrated that wedge-shaped consolidations were frequently associated with PE. In addition, localized pleural effusion was a typical finding in the presence of PE for both TS and MSCT. TS had moderate sensitivity and specificity compared with MSCT. Furthermore, the study revealed that PE is often associated with peripheral parenchymal changes, both of which are detectable by TS and MSCT. In case of contraindication with MSCT, TS is a potential technique for diagnosing PE-related parenchymal findings and can serve as an alternative method in the diagnosis of PE. However, a negative result with TS does not rule out a PE.
本研究旨在比较经胸超声（TS）与多层螺旋 CT（MSCT）在检测周围型肺栓塞（PE）中的作用。此外，本研究还验证了 TS 和 MSCT 对周围实质病变的显示。共纳入 33 例有疑似 PE 症状的患者（16 名女性，17 名男性；平均年龄=65.4 岁）。TS 和 MSCT 均在临床出现疑似 PE 症状的 24 小时内进行。10 例患者经 MSCT 证实为 PE。TS 检测 PE 的灵敏度为 70.0%，特异性为 69.6%。PE 和周围实质病变主要位于下叶。MSCT 显示的主要实质改变为寡血症。TS 显示楔形实变常与 PE 有关。此外，局部胸腔积液是 TS 和 MSCT 检测到 PE 的典型表现。与 MSCT 相比，TS 的灵敏度和特异性均适中。此外，本研究表明，PE 常伴有外周实质改变，TS 和 MSCT 均可检测到这些改变。在 MSCT 存在禁忌的情况下，TS 是一种诊断与 PE 相关的实质病变的潜在技术，可作为诊断 PE 的替代方法。然而，TS 检查结果阴性并不能排除 PE。
