Gray H W, Pearson D W, Moran F, Bessent R G
Eur J Nucl Med. 1984;9(4):151-3. doi: 10.1007/BF00251461.
Thirty-four hospital patients with suspected pulmonary embolism (PE) had ventilation perfusion (VP) imaging after pulmonary angiography to assess the performance of highly specific criteria for diagnosis of PE and to evaluate the precision of image reporting. A diagnostic result was obtained from VP imaging in 21 of 34 patients giving a sensitivity for PE of 80% and a specificity of 100% in this subgroup. Six of 11 patients with PE had an indeterminate study which reduced the overall sensitivity of the technique for PE in the whole group. A critical analysis of image reporting by two readers gave an 85% inter-observer agreement on ranking as diagnostic or indeterminate for PE (k 0.69) and 91%-94% agreement for consensus reproducibility (k 0.82). We conclude that the degree of accuracy and precision of reporting that can be obtained using specific criteria will provide a reliable diagnosis in a significant number of patients suspected of having PE. Consensus reporting by two readers is shown to be more reliable than individual reporting.
34名疑似肺栓塞（PE）的住院患者在肺血管造影后接受了通气灌注（VP）成像，以评估诊断PE的高度特异性标准的性能，并评估图像报告的准确性。34例患者中有21例通过VP成像获得了诊断结果，该亚组中PE的敏感性为80%，特异性为100%。11例PE患者中有6例检查结果不确定，这降低了该技术对全组PE的总体敏感性。两位阅片者对图像报告进行的批判性分析显示，在将PE诊断为阳性或不确定的分级上，观察者间一致性为85%（κ=0.69），在共识再现性方面一致性为91%-94%（κ=0.82）。我们得出结论，使用特定标准能够获得的报告准确性和精确程度，将为大量疑似患有PE的患者提供可靠诊断。结果表明，两位阅片者的共识报告比个人报告更可靠。
