急性心包炎中计算机断层扫描结果的准确性。
Accuracy of computed tomography findings in acute pericarditis.
作者信息
Hammer Mark M, Raptis Constantine A, Javidan-Nejad Cylen, Bhalla Sanjeev
机构信息
Mallinckrodt Institute of Radiology, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA
Mallinckrodt Institute of Radiology, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA.
出版信息
Acta Radiol. 2014 Dec;55(10):1197-202. doi: 10.1177/0284185113515866. Epub 2013 Dec 10.
BACKGROUND
Acute pericarditis is a close clinical mimic of pulmonary embolism (PE) in the emergency department, and thus many of these patients are evaluated with chest computed tomography (CT).
PURPOSE
To study whether CT findings can be diagnostic of acute pericarditis.
MATERIAL AND METHODS
Using the electronic medical record, we retrospectively identified 46 cases of acute pericarditis and 46 control patients with pericardial effusions due to volume overload, all of whom underwent CT examination. Cases were reviewed by two blinded academic thoracic radiologists.
RESULTS
The majority, 67%, of the pericarditis cases were evaluated with PE-protocol CTs. Pericardial thickening/enhancement was the most accurate single parameter for pericarditis, with sensitivity of 54-59% and specificity of 91-96%.
CONCLUSION
CT findings, while not sensitive for pericarditis, are diagnostic, with few false-positives. Radiologists should be attentive to pericardial thickening or enhancement on CT studies done for chest pain, as they may be able to suggest pericarditis as an alternative diagnosis for the chest pain.
背景
在急诊科，急性心包炎在临床上与肺栓塞（PE）极为相似，因此许多此类患者会接受胸部计算机断层扫描（CT）检查。
目的
研究CT检查结果能否诊断急性心包炎。
材料与方法
利用电子病历，我们回顾性地确定了46例急性心包炎患者以及46例因容量负荷过重导致心包积液的对照患者，所有患者均接受了CT检查。由两名不知情的胸科放射科专家对病例进行评估。
结果
大多数（67%）心包炎病例接受了PE方案CT检查。心包增厚/强化是诊断心包炎最准确的单一参数，敏感性为54 - 59%，特异性为91 - 96%。
结论
CT检查结果虽对心包炎不敏感，但具有诊断性，假阳性较少。放射科医生在对胸痛患者进行CT检查时应留意心包增厚或强化情况，因为这可能提示心包炎是胸痛的另一种诊断。
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