Bhoobalan Shanmugasundaram, Chakravartty Riddhika, Dolbear Gill, Al-Janabi Mazin
Department of Nuclear Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom.
Department of Medical Imaging, Canterbury Christ Church University, Canterbury, Kent, United Kingdom.
Indian J Nucl Med. 2013 Oct;28(4):221-5. doi: 10.4103/0972-3919.121967.
Aim of the study was to determine the accuracy of the clinical pretest probability (PTP) score and its association with lung ventilation and perfusion (VQ) scan.
A retrospective analysis of 510 patients who had a lung VQ scan between 2008 and 2010 were included in the study. Out of 510 studies, the number of normal, low, and high probability VQ scans were 155 (30%), 289 (57%), and 55 (11%), respectively.
A total of 103 patients underwent computed tomography pulmonary angiography (CTPA) scan in which 21 (20%) had a positive scan, 81 (79%) had a negative scan and one (1%) had an equivocal result. The rate of PE in the normal, low-probability, and high-probability scan categories were: 2 (9.5%), 10 (47.5%), and 9 (43%) respectively. A very low correlation (Pearson correlation coefficient r = 0.20) between the clinical PTP score and lung VQ scan. The area under the curve (AUC) of the clinical PTP score was 52% when compared with the CTPA results. However, the accuracy of lung VQ scan was better (AUC = 74%) when compared with CTPA scan.
The clinical PTP score is unreliable on its own; however, it may still aid in the interpretation of lung VQ scan. The accuracy of the lung VQ scan was better in the assessment of underlying pulmonary embolism (PE).
本研究旨在确定临床预测试概率（PTP）评分的准确性及其与肺通气灌注（VQ）扫描的相关性。
对2008年至2010年间进行肺VQ扫描的510例患者进行回顾性分析。在510项研究中，正常、低概率和高概率VQ扫描的数量分别为155例（30%）、289例（57%）和55例（11%）。
共有103例患者接受了计算机断层扫描肺动脉造影（CTPA）扫描，其中21例（20%）扫描结果为阳性，81例（79%）为阴性，1例（1%）结果不明确。正常、低概率和高概率扫描类别中的肺栓塞发生率分别为：2例（9.5%）、10例（47.5%）和9例（43%）。临床PTP评分与肺VQ扫描之间的相关性非常低（Pearson相关系数r = 0.20）。与CTPA结果相比，临床PTP评分的曲线下面积（AUC）为52%。然而，与CTPA扫描相比，肺VQ扫描的准确性更高（AUC = 74%）。
临床PTP评分本身不可靠；然而，它仍可能有助于肺VQ扫描的解读。肺VQ扫描在评估潜在肺栓塞（PE）方面的准确性更高。
