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基于 CT 的诊断在以咽喉痛为表现的患者中:单机构回顾。

CT-based diagnosis in patients presenting with throat pain: A single institutional review.

机构信息

Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, 1300 York Ave, New York, NY 10021, USA.

Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, 1300 York Ave, New York, NY 10021, USA.

出版信息

Am J Emerg Med. 2024 Jan;75:33-36. doi: 10.1016/j.ajem.2023.10.023. Epub 2023 Oct 22.

Abstract

RATIONALE AND OBJECTIVE

To determine if patient demographic data, medical history, physical examination, and laboratory tests will help predict likelihood of imaging-based diagnosis using CT of the neck performed in the ED for a chief complaint of throat pain.

MATERIAL AND METHODS

Single institutional, retrospective review of 367 CT scans of the neck performed for the evaluation of throat pain in the ED from August 2013 to September 2019. Patients' clinical history, physical exams, lab findings, and imaging results were recorded.

RESULTS

A total of 367 CT scans of the neck performed for the evaluation of throat pain included a recorded exam and clinical history. Of these cases, we noted that the presence of cervical lymphadenopathy (OR = 2.69; 95% CI, 1.37-5.49), tonsillar findings (OR = 2.94; 95% CI, 1.4-6.57), increased white blood cell count (OR = 1.08; 95% CI, 1.02-1.15), and temperature (OR = 1.94; 95% CI, 1.1-3.6) were associated with increased likelihood of obtaining a diagnostic CT scan.

CONCLUSION

Consideration of tonsillar abnormalities, lymphadenopathy, body temperature, and measured leukocyte count prior to ordering CT scans of the neck for throat pain may increase the diagnostic yield of such exams and decrease CT utilization in the ED.

摘要

背景与目的

确定患者的人口统计学数据、病史、体格检查和实验室检查是否有助于预测急诊科以咽喉痛为主要症状行颈部 CT 检查的成像诊断可能性。

材料与方法

对 2013 年 8 月至 2019 年 9 月期间在急诊科因咽喉痛行颈部 CT 检查的 367 例患者进行单中心、回顾性研究。记录患者的临床病史、体格检查、实验室检查和影像学结果。

结果

共对 367 例因咽喉痛行颈部 CT 检查的患者进行了记录检查和临床病史评估。在这些病例中,我们注意到颈淋巴结病(OR=2.69;95%CI,1.37-5.49)、扁桃体异常(OR=2.94;95%CI,1.4-6.57)、白细胞计数增加(OR=1.08;95%CI,1.02-1.15)和体温升高(OR=1.94;95%CI,1.1-3.6)与获得诊断性 CT 扫描的可能性增加相关。

结论

在因咽喉痛而行颈部 CT 检查前,考虑扁桃体异常、淋巴结病、体温和白细胞计数等因素,可能会提高此类检查的诊断率,并减少急诊科 CT 检查的使用。

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