Ahmad M, Fletcher J W, Pur-Shahriari A A, George E A, Donati R M
J Nucl Med. 1979 Apr;20(4):291-3.
In 102 patients suspected of pulmonary embolism, we have assessed the ability of a radionuclide (emission) venogram to complement the pulmonary perfusion scintigram in establishing a diagnosis. The efficacy was compared using decision analysis and Bayes's theorem. Two criteria for a positive test were compared: Criterion 1--the test is positive if the lung scan a) indicates a high probability of pulmonary embolus, or b) is abnormal but indeterminate for pulmonary embolus; Criterion 2--the test is positive a) if the lung scan indicates a high probability of pulmonary embolus, or b) if the emission venogram is positive in a patient with a lung scan considered abnormal but indeterminate for pulmonary embolus. The use of Criterion 2 decreased the sensitivity from 100% to 95% and increased the specificity from 74% to 93%. We conclude that a simultaneous emission venogram assists in improving the specificity, accuracy, and the predictive value of a standard pulmonary perfusion study in the diagnosis of pulmonary embolus.
在102例疑似肺栓塞的患者中，我们评估了放射性核素（发射）静脉造影在辅助肺灌注闪烁扫描以确立诊断方面的能力。采用决策分析和贝叶斯定理对其有效性进行了比较。比较了两种阳性检查标准：标准1——如果肺部扫描a）提示肺栓塞可能性高，或b）异常但肺栓塞情况不确定，则检查为阳性；标准2——如果肺部扫描a）提示肺栓塞可能性高，或b）在肺部扫描被认为异常但肺栓塞情况不确定的患者中发射静脉造影为阳性，则检查为阳性。使用标准2使敏感性从100%降至95%，特异性从74%增至93%。我们得出结论，同步发射静脉造影有助于提高标准肺灌注研究在诊断肺栓塞中的特异性、准确性和预测价值。
