Oser R F, Zuckerman D A, Gutierrez F R, Brink J A
Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, MO 63110, USA.
Radiology. 1996 Apr;199(1):31-5. doi: 10.1148/radiology.199.1.8633168.
To determine how often emboli detected angiographically in peripheral pulmonary arterial branches would be missed with cross-sectional imaging.
Seventy-nine of 88 consecutive pulmonary angiograms interpreted as positive for pulmonary emboli were reviewed retrospectively to detect pulmonary emboli. Three angiograms interpreted as negative when reviewed retrospectively were excluded. Findings of 76 angiograms in 76 patients (32 men, 44 women; aged 19-85 years) were correlated with the results of scintigraphy (n = 72) and Doppler ultrasound (n = 60), clinical presentation (n = 76), and follow-up with chart review (n = 72).
Two hundred five emboli were identified. Nineteen patients had solitary emboli. Sixty emboli were in the upper lobes. The largest arterial branch with pulmonary embolism was lobar in 14 patients, segmental in 38, subsegmental in 20, and smaller in three.
If cross-sectional imaging can depict emboli in only segmental and larger arterial branches, then emboli in 23 of 76 patients (30%) would have been missed with cross-sectional imaging.
确定经横断面成像检查时，外周肺动脉分支血管造影检测到的栓子漏诊的频率。
回顾性分析连续88例肺血管造影中79例被判定为肺栓塞阳性的病例，以检测肺栓塞情况。回顾性分析时判定为阴性的3例血管造影被排除。76例患者（32例男性，44例女性；年龄19 - 85岁）的76例血管造影结果与闪烁扫描（n = 72）、多普勒超声（n = 60）结果、临床表现（n = 76）以及通过查阅病历进行的随访结果（n = 72）进行相关性分析。
共识别出205个栓子。19例患者有单个栓子。60个栓子位于上叶。发生肺栓塞的最大动脉分支，14例为叶动脉，38例为段动脉，20例为亚段动脉，3例更小。
如果横断面成像仅能显示段动脉及更大动脉分支中的栓子，那么76例患者中有23例（30%）的栓子会被横断面成像漏诊。
