Khorasani R, Gudas T F, Nikpoor N, Polak J F
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
AJR Am J Roentgenol. 1997 Nov;169(5):1355-7. doi: 10.2214/ajr.169.5.9353458.
We compared patient treatment with imaging strategy in patients with clinically suspected pulmonary embolism (PE) and intermediate-probability lung scans (IPLS).
We retrospectively reviewed the medical records of 214 consecutive patients with clinically suspected PE with IPLS.
Treatment (full anticoagulation, filter placement, or both) was given in 66 (31%) of 214 patients. Only 37% of patients were treated on the basis of definitive diagnostic imaging results. Most patients (134 [63%] of 214) were treated without an imaging diagnosis: 30 (14%) of 214 patients were treated for acute PE on clinical grounds, and the diagnosis of PE was not excluded in 104 (49%) of 214 patients.
Most patients with IPLS are treated without a definitive imaging diagnosis. This lack of diagnosis may result in the overtreatment of patients who do not have acute PE or, more importantly, in the undertreatment of patients who do have acute PE. Further studies are necessary to evaluate the impact of the current management strategies on patient outcome.
我们比较了临床疑似肺栓塞（PE）且肺部扫描为中度可能性（IPLS）的患者的治疗与成像策略。
我们回顾性分析了214例连续的临床疑似PE且IPLS的患者的病历。
214例患者中有66例（31%）接受了治疗（全量抗凝、放置滤器或两者皆有）。仅37%的患者基于明确的诊断成像结果接受治疗。大多数患者（214例中的134例[63%]）在未进行成像诊断的情况下接受了治疗：214例患者中有30例（14%）基于临床原因接受了急性PE治疗，214例患者中有104例（49%）未排除PE诊断。
大多数IPLS患者在未进行明确成像诊断的情况下接受了治疗。这种诊断缺失可能导致对无急性PE患者的过度治疗，或者更重要的是，对有急性PE患者的治疗不足。有必要进一步研究以评估当前管理策略对患者结局的影响。
