Caracci B F, Rumbolo P M, Mainini S, Walker H S, Peterson G J
Department of Surgery, St. Louis University Medical Center, Missouri 63104.
Am J Surg. 1988 Dec;156(6):477-80. doi: 10.1016/s0002-9610(88)80533-6.
To evaluate the accuracy of ventilation-perfusion scanning in the diagnosis of pulmonary embolism, the pulmonary arteriograms of 55 patients suspected of pulmonary embolism were compared with their ventilation-perfusion scans. The clinical presentation was consistent for the diagnosis of pulmonary emboli in all 55 patients. The scans were divided into the following four categories according to standard guidelines: normal, low, intermediate, and high probability. Three patients had normal scans confirmed by arteriography; 34 patients had high-probability scans, but only 22 (65 percent) were positive at arteriography. The remaining 18 patients had low or intermediate-probability scans (9 patients each), 5 of whom (28 percent) were positive at angiography (sensitivity 82 percent, specificity 57 percent). This study demonstrates the inaccuracy of ventilation-perfusion scanning for the evaluation of pulmonary embolus and may represent the variability of interpretation at individual institutions. Perhaps each institution may need to compare the results of ventilation-perfusion scanning and angiography to optimally select and treat patients.
为评估通气-灌注扫描在诊断肺栓塞中的准确性，将55例疑似肺栓塞患者的肺动脉造影结果与其通气-灌注扫描结果进行了比较。所有55例患者的临床表现均符合肺栓塞的诊断。根据标准指南，扫描结果分为以下四类：正常、低度、中度和高度可能性。3例患者扫描结果正常，动脉造影证实；34例患者扫描结果为高度可能性，但动脉造影仅22例（65%）呈阳性。其余18例患者扫描结果为低度或中度可能性（各9例），其中5例（28%）血管造影呈阳性（敏感性82%，特异性57%）。本研究表明通气-灌注扫描在评估肺栓塞方面不准确，可能代表了各机构解读结果的差异。或许每个机构都需要比较通气-灌注扫描和血管造影的结果，以便优化患者的选择和治疗。
