Grier D J, Watson L J, Hartnell G G, Wilde P
Department of Clinical Radiology, Bristol Royal Infirmary.
Clin Radiol. 1993 Aug;48(2):131-3. doi: 10.1016/s0009-9260(05)81088-8.
Chest radiographs are frequently requested prior to diagnostic angiography, though there is no published evidence of their clinical utility. This study was undertaken to evaluate their contribution to patient management. The routine chest radiographs obtained prior to peripheral and coronary angiography in 240 patients were prospectively reviewed for abnormalities likely to affect management. Two hundred and twenty (91.7%) examinations were performed, of which 164 were obtained within 24 h of angiography. Previous radiographs were available in 154 patients (64.2%). One hundred and sixteen radiographs were normal. There were 117 abnormalities on the radiographs of 104 patients, mainly cardiac enlargement and heart failure. No angiogram was postponed or cancelled because of abnormalities detected on a routine radiograph, although radiographic findings led to a change in the volume of contrast medium injected into dilated aortic roots in 10 patients undergoing cardiac catheterization. Pre-angiography radiographs had no effect on the practice of peripheral angiography. In only one patient were further investigations and therapy instigated because of findings, but even in this case these findings were present on previous studies. We conclude that routine pre-angiography chest radiographs are not necessary in the absence of specific clinical indications.
尽管尚无已发表的证据表明胸部X光片在诊断性血管造影术前的临床效用，但临床仍经常要求进行此项检查。本研究旨在评估其对患者管理的作用。前瞻性地回顾了240例患者在进行外周血管造影和冠状动脉造影术前获得的常规胸部X光片，以查找可能影响治疗的异常情况。共进行了220例（91.7%）检查，其中164例是在血管造影术24小时内获得的。154例患者（64.2%）有之前的X光片。116例X光片正常。104例患者的X光片上有117处异常，主要是心脏扩大和心力衰竭。尽管X光片的检查结果致使10例接受心导管插入术的患者在向扩张的主动脉根部注射造影剂的量上有所改变，但没有因为常规X光片上检测到的异常而推迟或取消任何血管造影检查。血管造影术前的X光片对外周血管造影检查的操作没有影响。只有1例患者因检查结果而进行了进一步检查和治疗，但即便在此病例中，这些结果在之前的检查中就已存在。我们得出结论，在没有特定临床指征的情况下，血管造影术前的常规胸部X光片并非必要。
