Bergin C J, Sirlin C B, Hauschildt J P, Huynh T V, Auger W R, Fedullo P F, Kapelanski D P
Department of Radiology, University of California, San Diego 92103-8756, USA.
Radiology. 1997 Sep;204(3):695-702. doi: 10.1148/radiology.204.3.9280245.
To evaluate the accuracy of identification of central and segmental chronic thromboembolic disease on helical computed tomographic (CT) scans and on magnetic resonance (MR) images.
Radiologic findings in 55 patients suspected of having chronic thromboembolic pulmonary hypertension were analyzed; these included findings from angiography (n = 55), helical CT (n = 47), and MR imaging (n = 26). Forty patients underwent thromboendarterectomy. CT and MR images were independently interpreted by two readers for the presence of thromboembolic material in central and segmental vessels. Surgical findings and angiographic findings were the reference standards for disease in central and segmental vessels, respectively.
Central vessel disease was determined more accurately with helical CT scans (accuracy of 0.79 for each of the two readers) than with angiograms (accuracy of 0.74) or with MR images (accuracy of 0.39 and 0.46 for two readers). Segmental vessel disease was also more accurately determined with CT scans (accuracy of 0.75 and 0.76 for two readers) than with MR images (accuracy of 0.61 and 0.57 for two readers).
Helical CT is a useful alternative to conventional angiography for diagnosis of chronic thromboembolism but may not be sufficient for selecting candidates for surgery in all cases.
评估螺旋计算机断层扫描（CT）和磁共振成像（MR）对中央型和节段型慢性血栓栓塞性疾病的识别准确性。
分析了55例疑似慢性血栓栓塞性肺动脉高压患者的影像学表现；这些表现包括血管造影（n = 55）、螺旋CT（n = 47）和MR成像（n = 26）的结果。40例患者接受了血栓内膜切除术。CT和MR图像由两位阅片者独立解读，以确定中央和节段血管内是否存在血栓栓塞物质。手术结果和血管造影结果分别作为中央和节段血管疾病的参考标准。
与血管造影（准确率0.74）或MR图像（两位阅片者的准确率分别为0.39和0.46）相比，螺旋CT扫描对中央血管疾病的诊断更准确（两位阅片者的准确率均为0.79）。与MR图像（两位阅片者的准确率分别为0.61和0.57）相比，CT扫描对节段血管疾病的诊断也更准确（两位阅片者的准确率分别为0.75和0.76）。
螺旋CT是诊断慢性血栓栓塞的一种有用的替代传统血管造影的方法，但在所有情况下可能不足以筛选手术候选者。
