Stankiewicz J A, Bowes A K
Laryngoscope. 1985 Oct;95(10):1159-60. doi: 10.1288/00005537-198510000-00001.
Because of the controversy regarding the benefits of the lateral neck and chest radiographs in the evaluation of croup and epiglottitis, a two-part retrospective study was initiated. Part I consisted of a retrospective chart review of 44 patients with a final diagnosis of croup and epiglottitis. Part II consisted of the 42 lateral neck and chest x-rays from patients in part I presented to six radiologists who knew only the patients age and the history of respiratory distress. Two hundred forty-six responses were obtained. The results of the part I study showed that 64% of patients with documented epiglottitis had a positive radiologic diagnosis. Only 33% of patients with croup had a positive radiologic diagnosis and importantly 27% had a diagnosis of possible epiglottitis. The results of part II showed 38% of the documented epiglottitis patients had a positive lateral neck radiograph. The croup patients had a lateral neck and/or chest x-ray positive in 38%. Of interest, 24% had readings consistent with possible epiglottitis. Based on this two-part study, it is our conclusion that the lateral neck and chest x-ray may be unreliable and inaccurate in the diagnosis of croup and epiglottitis. Caution and good clinical judgement should be utilized when interpreting these x-rays.
由于在评估喉炎和会厌炎时，关于颈部侧位片和胸部X线片的益处存在争议，因此开展了一项分为两部分的回顾性研究。第一部分包括对44例最终诊断为喉炎和会厌炎的患者进行回顾性病历审查。第二部分包括将第一部分患者的42张颈部侧位片和胸部X线片提供给6位放射科医生，这些医生仅知道患者的年龄和呼吸窘迫病史。共获得246份反馈。第一部分研究结果显示，有记录的会厌炎患者中64%有阳性放射学诊断。喉炎患者中只有33%有阳性放射学诊断，重要的是27%被诊断为可能患有会厌炎。第二部分结果显示，有记录的会厌炎患者中38%颈部侧位片呈阳性。喉炎患者颈部侧位片和/或胸部X线片阳性率为38%。有趣的是，24%的诊断结果与可能患有会厌炎相符。基于这项分为两部分的研究，我们的结论是，颈部侧位片和胸部X线片在喉炎和会厌炎的诊断中可能不可靠且不准确。在解读这些X线片时应谨慎并运用良好的临床判断力。
