Lawhn-Heath Courtney, Buckle Christopher, Christoforidis Gregory, Straus Christopher
University of Chicago Pritzker School of Medicine, 924 East 57th Street #104, Chicago, IL 60637, USA.
Emerg Radiol. 2013 Jan;20(1):45-9. doi: 10.1007/s10140-012-1071-y. Epub 2012 Sep 2.
Acute dizziness (including vertigo) is a common reason to visit the emergency room, and imaging with head CT is often performed initially to exclude a central cause. In this study, consecutive patients presenting with dizziness and undergoing head CT were retrospectively reviewed to determine diagnostic yield. Four hundred forty-eight consecutive head CTs in a representative sample of dizzy emergency room (ER) patients, including patients with other neurological symptoms, were reviewed to identify an acute or subacute cause for acute dizziness along with the frequency and modalities used in follow-up imaging. The diagnostic yield for head CT ordered in the ER for acute dizziness is low (2.2 %; 1.6 % for emergent findings), but MRI changes the diagnosis up to 16 % of the time, acutely in 8 % of cases. Consistent with the American College of Radiology appropriateness criteria and the literature, this study suggests a low diagnostic yield for CT in the evaluation of acute dizziness but an important role for MRI in appropriately selected cases.
急性头晕（包括眩晕）是急诊就诊的常见原因，最初常进行头部CT成像以排除中枢性病因。在本研究中，对连续出现头晕并接受头部CT检查的患者进行回顾性分析以确定诊断率。对448例头晕急诊患者（包括伴有其他神经症状的患者）的代表性样本进行连续头部CT检查，以确定急性头晕的急性或亚急性病因以及后续成像检查的频率和方式。急诊室针对急性头晕进行的头部CT诊断率较低（2.2%；急诊发现为1.6%），但MRI在高达16%的病例中改变了诊断结果，其中8%为急性病例。与美国放射学会的适宜性标准及文献一致，本研究表明CT在评估急性头晕时诊断率较低，但MRI在适当选择的病例中具有重要作用。
