Department of Radiology, Hospital of the University of Pennsylvania, MRI Learning Center, 3400 Spruce St., Philadelphia, PA 19104, USA.
AJR Am J Roentgenol. 2010 Jan;194(1):W38-48. doi: 10.2214/AJR.09.2694.
The utility of various imaging techniques and strategies for the diagnosis of pulmonary embolism has been studied in randomized control trials and extensively described in the literature. CT and ventilation-perfusion scintigraphy are the mainstays of diagnosis, and MRI is emerging. The purpose of this study was to assess the diagnostic approach to pulmonary embolism practiced by emergency physicians and advised by radiologists.
Questionnaires were sent to emergency physicians and radiologists in Pennsylvania. The questions covered diagnostic strategies for the detection of pulmonary embolism in the usual situations and in clinical circumstances in which the primary imaging technique is considered less desirable.
Sixty-two radiologists and 52 emergency physicians completed the survey. Ninety percent of radiologists and 96% of emergency physicians answered that CT was their first-line choice for the diagnosis of pulmonary embolism. The use of ventilation-perfusion scintigraphy increased in the care of patients with renal failure and allergy to iodinated contrast material. MRI was chosen infrequently.
CT is the overwhelmingly preferred technique for the diagnosis of pulmonary embolism. The role of ventilation-perfusion scintigraphy increases when the use of iodinated contrast material is contraindicated. MRI does not seem to have an important role in practice.
各种影像学技术和策略在随机对照试验中已被用于诊断肺栓塞，并在文献中得到广泛描述。CT 和通气灌注闪烁显像术是诊断的主要方法，而 MRI 也正在兴起。本研究旨在评估急诊医师采用的、并由放射科医师推荐的肺栓塞诊断方法。
调查问卷被发送给宾夕法尼亚州的急诊医师和放射科医师。问题涵盖了在常见情况下以及在首选影像学技术不太理想的临床情况下检测肺栓塞的诊断策略。
62 名放射科医师和 52 名急诊医师完成了调查。90%的放射科医师和 96%的急诊医师回答说，CT 是他们诊断肺栓塞的首选方法。在肾衰竭和对碘造影剂过敏的患者的治疗中，通气灌注闪烁显像术的使用增加了。MRI 的选择则很少。
CT 是诊断肺栓塞的首选技术。当使用碘造影剂受到限制时，通气灌注闪烁显像术的作用会增加。MRI 在实践中似乎没有重要作用。
