Ockelford P A, Rutland M
Aust N Z J Med. 1986 Apr;16(2):216-20. doi: 10.1111/j.1445-5994.1986.tb01152.x.
Three hundred and one consecutive lung scans were reviewed to determine the frequency of the different ventilation perfusion scan patterns and their use in the management of suspected pulmonary embolism. Based on the original report, an accurate diagnosis was possible in 99 patients (33%). Within this group pulmonary embolism was excluded by a normal lung scan in 35 (12%), and confirmed in 64 (21%) patients having a high probability pattern. There were 194 (64%) patients with a low probability scan, but in only 24 of these (12%) was venous thromboembolism objectively confirmed or excluded by additional investigations. Although the low probability scan is non-specific, the scan result was used as the sole objective test to determine therapy in 170 patients (56%). The clinical decision was to withhold anticoagulants in 143 patients and to treat 27 patients. Probability estimates using Bayes' Theorem have been applied to evaluate these management decisions.
回顾了301例连续的肺部扫描，以确定不同通气灌注扫描模式的频率及其在疑似肺栓塞管理中的应用。根据原始报告，99例患者（33%）可做出准确诊断。在这组患者中，35例（12%）肺部扫描正常排除了肺栓塞，64例（21%）具有高概率模式的患者确诊为肺栓塞。有194例（64%）患者扫描概率较低，但其中只有24例（12%）通过进一步检查客观地证实或排除了静脉血栓栓塞。尽管低概率扫描不具有特异性，但在170例患者（56%）中，扫描结果被用作确定治疗方案的唯一客观检查。临床决策是143例患者停用抗凝剂，27例患者进行治疗。已应用贝叶斯定理的概率估计来评估这些管理决策。
