Winer-Muram H T, Rubin S A, Fletcher B D, Kauffman W M, Jennings S G, Arheart K L, Bozeman P M
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN 38101-0318.
Radiology. 1994 Oct;193(1):127-33. doi: 10.1148/radiology.193.1.8090880.
To determine the diagnostic accuracy of bedside chest radiography in patients who develop severe pulmonary complications while undergoing therapy for leukemia.
The authors studied 45 patients, aged 21 years and younger, who died of leukemia or of treatment complications and for whom autopsy findings were available. Pulmonary findings at autopsy comprised pneumonia (n = 25), adult respiratory distress syndrome (ARDS) (n = 16), hemorrhage (n = 38), infarction (n = 18), and leukemic cellular infiltration (n = 11). Four radiologists who were unaware of the autopsy diagnoses independently rated antemortem bedside chest radiographs.
Diagnostic accuracy for each disease was as follows: ARDS, 0.81 +/- .03 (standard error); all pneumonias, 0.56 +/- .04; hemorrhage, 0.47 +/- .07; infarction, 0.50 +/- .12; and pulmonary leukemic cellular infiltration, 0.38 +/- .12.
The specific radiographic appearance of ARDS permits excellent diagnostic accuracy.
确定在接受白血病治疗过程中发生严重肺部并发症的患者床边胸部X线摄影的诊断准确性。
作者研究了45例年龄在21岁及以下、死于白血病或治疗并发症且有尸检结果的患者。尸检时的肺部表现包括肺炎（n = 25）、成人呼吸窘迫综合征（ARDS）（n = 16）、出血（n = 38）、梗死（n = 18）和白血病细胞浸润（n = 11）。4名不知道尸检诊断结果的放射科医生独立对生前床边胸部X线片进行评级。
每种疾病的诊断准确性如下：ARDS为0.81±0.03（标准误差）；所有肺炎为0.56±0.04；出血为0.47±0.07；梗死为0.50±0.12；肺部白血病细胞浸润为0.38±0.12。
ARDS的特定影像学表现具有极高诊断准确性。
