Lamme T, Nijhout M, Cadman D, Milner R, Zylak C, Jacobs J, Gill G, McNamee J
CMAJ. 1986 Feb 15;134(4):353-6.
Although expert committees have questioned the usefulness of lateral radiologic views of the chest without specific indications, many physicians commonly order both posteroanterior and lateral views in assessing pediatric patients who have signs and symptoms of acute chest disease. To investigate the usefulness of lateral view in children, three experienced physicians independently reviewed and interpreted the posteroanterior view alone and the posteroanterior and lateral views for 179 children 1 to 10 years of age. The films were made between 1980 and 1982 at McMaster University Medical Centre, Hamilton, Ont. A high level of agreement was found between the interpretations based on the posteroanterior view alone and those based on both views. Addition of the lateral view did not improve agreement between the interpretations and the final hospital chart radiologic diagnosis in a clinically significant manner, nor did the lateral view improve the accuracy of localization of radiologic abnormalities. Obtaining a lateral view whenever radiologic examination of the chest is indicated but when specific indications are lacking is unlikely to prove useful to experienced physicians in diagnosing and managing acute pulmonary illness in children.
尽管专家委员会对无特定指征的胸部侧位影像学检查的实用性提出了质疑，但许多医生在评估有急性胸部疾病体征和症状的儿科患者时，通常会同时开具后前位和侧位胸片。为了研究侧位胸片在儿童中的实用性，三位经验丰富的医生独立对179名1至10岁儿童的后前位胸片以及后前位和侧位胸片进行了审查和解读。这些胸片于1980年至1982年在安大略省汉密尔顿市的麦克马斯特大学医疗中心拍摄。结果发现，仅基于后前位胸片的解读与基于两种胸片的解读之间存在高度一致性。添加侧位胸片并没有以临床上显著的方式提高解读与最终医院病历放射学诊断之间的一致性，侧位胸片也没有提高放射学异常定位的准确性。在有胸部放射学检查指征但缺乏特定指征时常规获取侧位胸片，对于有经验的医生诊断和处理儿童急性肺部疾病不太可能被证明是有用的。
