Karaoglu Oguzhan, Tertemiz Kemal Can, Yilmaz Erkan, Akkoclu Atila, Çullu Neşat, Elibol Cenk, Elibol Funda Dinc
Department of Radiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
Department of Pulmonology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
Kardiochir Torakochirurgia Pol. 2014 Dec;11(4):445-51. doi: 10.5114/kitp.2014.47351. Epub 2014 Nov 30.
To investigate the effectiveness of indirect computed tomography (CT) venography applied after pulmonary CT angiography to patients with suspected pulmonary embolism.
The study comprised 80 patients at high/moderate risk of pulmonary embolism (PE) according to the clinical findings. Computed tomography venography (CTV) was performed 3-3.5 minutes after taking pulmonary CTA images. Color Doppler ultrasonography (CDUS) of the lower extremities was applied to all patients before pulmonary CTA or within 24 hours after CTA.
Pulmonary embolism was determined in a total of 19 patients (23%). Six patients had deep venous thrombosis on CTV examination even though the CDUS findings were normal. Accepting color Doppler ultrasonography findings as the gold standard, the sensitivity of CTV in determining deep vein thrombosis (DVT) was found to be 100%, specificity 91%, positive predictive value 60%, negative predictive value 100%, likelihood of giving a positive result 11.1, and likelihood of giving a negative result 0. There was a statistically significant good degree of correlation between the two methods (r = 0.741, p < 0.001).
Computed tomography venography examination applied after pulmonary CTA is a fast imaging technique that has high diagnostic value and can be an alternative to CDUS, especially when CDUS is insufficient in application and evaluation.
探讨对疑似肺栓塞患者在进行肺部CT血管造影后应用间接CT静脉造影的有效性。
根据临床检查结果，本研究纳入了80例肺栓塞（PE）高/中度风险患者。在获取肺部CTA图像后3 - 3.5分钟进行CT静脉造影（CTV）。所有患者在进行肺部CTA前或CTA后24小时内接受下肢彩色多普勒超声检查（CDUS）。
共19例患者（23%）确诊为肺栓塞。6例患者CTV检查发现有深静脉血栓形成，尽管CDUS检查结果正常。以彩色多普勒超声检查结果作为金标准，发现CTV在诊断深静脉血栓形成（DVT）方面的敏感性为100%，特异性为91%，阳性预测值为60%，阴性预测值为100%，阳性结果似然比为11.1，阴性结果似然比为0。两种方法之间存在统计学上显著的良好相关性（r = 0.741，p < 0.001）。
肺部CTA后应用CT静脉造影检查是一种快速成像技术，具有较高的诊断价值，尤其在CDUS应用和评估不足时，可作为CDUS的替代方法。
