Department of Emergency Medicine, Izmir Ataturk Research and Training Hospital, Izmir, Turkey. erolerdenun @ yahoo.com
Med Princ Pract. 2012;21(6):534-7. doi: 10.1159/000339116. Epub 2012 May 31.
The objective of this study was to evaluate the ability of emergency physicians (EPs) to diagnose early ischemic changes due acute ischemic stroke on cranial computed tomography (CT).
Three EPs interpreted CT scans obtained within 3 h of symptom onset in 50 patients with acute stroke. The CT scans were interpreted by the EPs and compared to official neuroradiologist reports as a gold standard. ĸ statistics were calculated to determine agreement among the three readers. Sensitivities and specificities were analyzed for each reader.
The EPs' sensitivities were 50, 45.5, and 45.5%, and specificities were 64.3, 82.1, and 64.3%, respectively. Focal parenchymal hypodensity was the criterion for which the EPs were the most sensitive (77.3%). The ability of EPs to recognize early ischemic changes on CT scans in acute ischemic stroke was moderate based on sensitivities.
Based on this study, EPs must be trained especially for recognizing early ischemic changes in acute ischemic stroke to improve their accuracy of interpretation.
本研究旨在评估急诊医师（EP）在头颅 CT 上诊断急性缺血性卒中早期缺血性改变的能力。
3 名 EP 对 50 例急性卒中患者发病后 3 小时内获得的 CT 扫描进行解读。EP 对 CT 扫描的解读与官方神经放射学家的报告进行比较，作为金标准。使用 κ 统计量来确定三位读者之间的一致性。对每位读者进行敏感性和特异性分析。
EP 的敏感性分别为 50%、45.5%和 45.5%，特异性分别为 64.3%、82.1%和 64.3%。局灶性实质密度降低是 EP 最敏感的标准（77.3%）。根据敏感性，EP 对 CT 扫描中急性缺血性卒中早期缺血性改变的识别能力为中等。
基于本研究，必须对 EP 进行专门培训，以提高其对急性缺血性卒中早期缺血性改变的解读准确性。
