Sostman H D, Coleman R E, DeLong D M, Newman G E, Paine S
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Radiology. 1994 Oct;193(1):103-7. doi: 10.1148/radiology.193.1.8090877.
To evaluate the accuracy of the revised PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) criteria for categorization of ventilation-perfusion lung scans and to compare the diagnostic accuracy of the revised criteria with that of the original PIOPED criteria and subjective probability estimates.
The ventilation-perfusion scans of 104 consecutive patients with suspected pulmonary embolism were reviewed. All patients had also undergone pulmonary angiography. The scans were categorized according to the original and revised PIOPED criteria, and a "gestalt" percent probability estimate was made. In addition, the official clinical interpretation (made with the original PIOPED criteria) was recorded.
The gestalt percent probability estimate was the most accurate for assessing the likelihood of pulmonary embolism (area under the receiver operating characteristic [ROC] curve = 0.836). The revised PIOPED criteria (area under the ROC curve = 0.753) were more accurate than the original PIOPED criteria.
The revised PIOPED criteria are more accurate than the original PIOPED criteria. Experienced readers of lung scans can achieve higher accuracy after applying formal criteria by using their experience and subjective judgment.
评估修订后的PIOPED（肺栓塞诊断前瞻性研究）标准对通气灌注肺扫描进行分类的准确性，并将修订标准的诊断准确性与原始PIOPED标准及主观概率估计的准确性进行比较。
回顾了104例连续疑似肺栓塞患者的通气灌注扫描。所有患者均接受了肺血管造影。根据原始和修订后的PIOPED标准对扫描进行分类，并进行“整体”概率百分比估计。此外，记录官方临床解读（采用原始PIOPED标准）。
“整体”概率百分比估计在评估肺栓塞可能性方面最为准确（受试者操作特征曲线下面积=0.836）。修订后的PIOPED标准（受试者操作特征曲线下面积=0.753）比原始PIOPED标准更准确。
修订后的PIOPED标准比原始PIOPED标准更准确。经验丰富的肺扫描阅片者在应用正式标准后，通过运用其经验和主观判断可获得更高的准确性。
