Teigen C L, Maus T P, Sheedy P F, Stanson A W, Johnson C M, Breen J F, McKusick M A
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Radiology. 1995 Feb;194(2):313-9. doi: 10.1148/radiology.194.2.7824704.
To determine the sensitivity and specificity of contrast material-enhanced electron-beam computed tomography (CT) in the diagnosis of pulmonary embolism (PE).
Sixty patients suspected of having PE were prospectively evaluated with pulmonary angiography and contrast-enhanced electron-beam CT. Thirty-eight patients underwent ventilation-perfusion (V-P [also known as V/Q]) scanning. The pulmonary vasculature was divided into 12 anatomic zones. CT and angiographic findings were correlated on a patient-by-patient basis and for each vascular zone.
Both studies were negative for PE in 36 patients. Both studies were positive in 15 patients, with the site of the emboli correlating well. Prospective sensitivity of CT was 65%; specificity, 97%; positive predictive value, 94%; and negative predictive value, 82%. After review of the nine discordant cases, sensitivity and specificity approached 100% for clinically important acute PE. CT depicted central and peripheral emboli equally well. CT was more sensitive and specific than V-P scanning.
Electron-beam CT is a sensitive and specific noninvasive method for the diagnosis of PE. It has the potential to replace V-P scanning as the primary screening examination for PE.
确定对比剂增强电子束计算机断层扫描（CT）在诊断肺栓塞（PE）中的敏感性和特异性。
对60例疑似患有PE的患者进行前瞻性评估，采用肺血管造影和对比增强电子束CT检查。38例患者接受了通气-灌注（V-P[也称为V/Q]）扫描。将肺血管系统分为12个解剖区域。逐例患者并针对每个血管区域对CT和血管造影结果进行相关性分析。
两项检查对36例患者的PE诊断均为阴性。两项检查对15例患者的诊断均为阳性，栓子部位相关性良好。CT的前瞻性敏感性为65%；特异性为97%；阳性预测值为94%；阴性预测值为82%。在对9例不一致的病例进行复查后，对于具有临床意义的急性PE，敏感性和特异性接近100%。CT对中央型和周围型栓子的显示同样良好。CT比V-P扫描更敏感、更具特异性。
电子束CT是一种敏感且特异的诊断PE的无创方法。它有可能取代V-P扫描作为PE的主要筛查检查。
