Gray H W, Bessent R G
Department of Nuclear Medicine, Royal Infirmary University NHS Trust, Alexandra Parade, Glasgow, UK.
Eur J Nucl Med. 1998 Mar;25(3):271-6. doi: 10.1007/s002590050228.
A recent trend among physicians is the categorisation of lung scans as normal [excludes pulmonary embolism (PE)], high probability (confirms PE) and non-diagnostic (no judgement on PE risk). The low probability scan is therefore being eliminated as a functional category. This occasional survey contends that such an approach is misguided. Correction of the original PIOPED data with certain assumptions provides a more reproducible, albeit restricted, low probability scan category which excludes PE in 97% of cases in the low pre-test clinical category. Patients with a low probability scan with risk factors for PE (i.e. medium clinical risk) will require further investigation. More important, the very low probability scan category excludes PE in 98% of patients with low and more than 92% of patients with medium pre-test clinical likelihood. The demise of "low probability" is premature.
医生中最近的一个趋势是将肺部扫描分为正常（排除肺栓塞（PE））、高概率（确诊PE）和非诊断性（对PE风险无判断）。因此，低概率扫描作为一个功能类别正在被淘汰。这项偶然的调查认为这种方法是错误的。用某些假设对原始PIOPED数据进行校正，可提供一个更具可重复性（尽管有限）的低概率扫描类别，该类别在低预测试临床类别中97%的病例中排除了PE。有PE风险因素（即中等临床风险）的低概率扫描患者需要进一步检查。更重要的是，极低概率扫描类别在98%的低预测试临床可能性患者和92%以上的中等预测试临床可能性患者中排除了PE。“低概率”的消亡为时过早。
