核医学技术人员能够准确地确定何时需要进行心肌灌注休息研究。

Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary.

机构信息

Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, Inga Marie Nilssons gata 49, 205 05, Malmö, Sweden.

出版信息

BMC Med Inform Decis Mak. 2012 Sep 4;12:97. doi: 10.1186/1472-6947-12-97.

DOI:10.1186/1472-6947-12-97

PMID:22947251

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3457849/

Abstract

BACKGROUND

In myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. If the stress study is considered normal, there is no need for a subsequent rest study. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study.

METHODS

Gated MPS using a 2-day 99mTc protocol for 121 consecutive patients were studied. Visual interpretation by 3 physicians was used as gold standard for determining the need for a rest study based on the stress images. All nuclear medicine technologists performing MPS had to review 82 training cases of stress MPS images with comments regarding the need for rest studies, and thereafter a test consisting of 20 stress MPS images. After passing this test, the nuclear medicine technologists in charge of a stress MPS study assessed whether a rest study was needed or not or if he/she was uncertain and wanted to consult a physician. After that, the physician in charge interpreted the images and decided whether a rest study was required or not.

RESULTS

The nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study. In the remaining 14 cases the technologists were uncertain, i.e. wanted to consult a physician. The agreement between the technologists and the physicians in clinical routine was very good, resulting in a kappa value of 0.92. There was no statistically significant difference in the evaluations made by technicians and physicians (P = 0.617).

CONCLUSIONS

The nuclear medicine technologists were able to accurately determine whether a rest study was necessary. There was very good agreement between nuclear medicine technologists and physicians in the assessment of the need for a rest study. If the technologists can make this decision, the effectiveness of the nuclear medicine department will improve.

摘要

背景

在心肌灌注闪烁显像（MPS）中，通常进行负荷和静息研究。如果负荷研究被认为正常，则无需进行随后的静息研究。本研究旨在确定核医学技术人员是否能够评估是否需要进行静息研究。

方法

对 121 例连续患者使用 2 天 99mTc 方案进行门控 MPS。视觉解读由 3 位医师作为金标准，根据负荷图像判断是否需要进行静息研究。所有进行 MPS 的核医学技术人员必须查看 82 例负荷 MPS 图像的培训案例，并对是否需要进行静息研究发表评论，然后进行 20 例负荷 MPS 图像的测试。通过此测试后，负责 MPS 负荷研究的核医学技术人员评估是否需要进行静息研究，或者他/她是否不确定并希望咨询医生。之后，负责的医生对图像进行解读并决定是否需要进行静息研究。

结果

在 107 例技术人员确定需要进行静息研究的病例中，核医学技术人员和临床常规医生有 103 例（96%）达成一致。在其余 14 例病例中，技术人员不确定，即希望咨询医生。技术人员和临床常规医生之间的一致性非常好，kappa 值为 0.92。技术人员和医生的评估之间没有统计学上的显著差异（P = 0.617）。