Ehrlich Romy, Lowe Sandra
Royal Hospital for Women, University of New South Wales, Australia.
Obstet Med. 2024 Jun;17(2):92-95. doi: 10.1177/1753495X231197563. Epub 2023 Sep 11.
Pulmonary embolism (PE) can be fatal yet difficult to diagnose in pregnancy. Computed tomography pulmonary angiogram (CTPA) or ventilation/perfusion (V/Q) scans are often conducted, potentially leading to low positive scan rates.
Retrospective data analysis was conducted for pregnant women and non-pregnant age-matched control who underwent CTPA and/or V/Q scan for investigation of PE. The main outcomes were the positive and non-diagnostic imaging rates.
In total, 440 women underwent V/Q or CTPA scans, 86 of whom were pregnant (19.5%). The positive scan rate was 3.5% and 8.8% in the pregnant and non-pregnant groups, respectively ( = 0.1). The non-diagnostic scan rate was similar between pregnant and non-pregnant groups (13.9% vs 9.9%, = 0.3). Within the pregnant group, there were more non-diagnostic CTPAs than V/Q scans ( = 0.005).
Our study confirms a low positive imaging rate and a relatively high non-diagnostic CTPA rate in pregnancy. Newer strategies are needed to reduce the number of negative imaging studies conducted.
肺栓塞（PE）在妊娠期可能致命，但诊断困难。通常会进行计算机断层扫描肺动脉造影（CTPA）或通气/灌注（V/Q）扫描，这可能导致扫描阳性率较低。
对接受CTPA和/或V/Q扫描以排查PE的孕妇及年龄匹配的非孕妇进行回顾性数据分析。主要结局指标为影像学检查的阳性率和非诊断性率。
共有440名女性接受了V/Q或CTPA扫描，其中86名是孕妇（19.5%）。孕妇组和非孕妇组的扫描阳性率分别为3.5%和8.8%（P = 0.1）。孕妇组和非孕妇组的非诊断性扫描率相似（13.9%对9.9%，P = 0.3）。在孕妇组中，非诊断性CTPA比V/Q扫描更多（P = 0.005）。
我们的研究证实，妊娠期影像学检查的阳性率较低，非诊断性CTPA率相对较高。需要新的策略来减少阴性影像学检查的数量。
