Chest:LDQ与CTPA对妊娠期肺栓塞的诊断价值!

2017-08-18 xing.T MedSci原创

妊娠期PE的诊断较为少见。LDQ和CTPA均表现良好,LDQ具有较低的母婴辐射暴露。因此,在使用时,LDQ是胸片阴性疑似PE孕妇的首选检查方式。

正常妊娠的反应会掩盖肺栓塞(PE)的症状。有限的文献表明,小剂量灌注扫描(LDQ),其比CT肺血管造影(CTPA)能更好地降低母婴的辐射,在排除孕妇PE上性能更好。

近日,呼吸领域权威杂志chest上发表了一篇研究文章,研究人员纳入了在2008年至2013年期间在Montefiore医学中心接受LDQ或CTPA成像检查以排查PE的孕妇进行了回顾性队列研究。研究人员的做法是建议胸片检查结果阴性的患者进行LDQ。研究人员根据初始成像方式对患者进行分类,并对哮喘患者进行亚组分析。该研究的主要结果为90天内静脉血栓栓塞诊断确定的影像检查阴性预测值(NPV)。

该研究共纳入了322名孕妇[平均年龄为27.3±6.3岁],最初成像检查中LDQs的PE阳性率为2.7%(6/225),而CTPAs为4.1%(4/97),LDQs的PE阴性率为88%(198/225)和而CTPAs为86.6%(84/97),不确定的/不能诊断的在LDQs为9.3%(21/225),而CTPAs为9.3%(9/97)(P=0.79)。共有10名患者接受PE治疗(3.1%)。LDQ的NPV为100%,CTPA为97.5%。哮喘患者的亚组分析中,23.9%的患者在LDQ和CTPA组中表现出了较高的负性结果的可能性,分别为74.1%和87%,两种方式的NPV均为100%。

妊娠期PE的诊断较为少见。LDQ和CTPA均表现良好,LDQ具有较低的母婴辐射暴露。因此,在使用时,LDQ是胸片阴性疑似PE孕妇的首选检查方式。

原始出处:

Jean-Ju Sheen, et al. Performance of Low Dose Perfusion Scintigraphy and Computed Tomographic Pulmonary Angiography for Pulmonary Embolism in Pregnancy.chest.2017. http://dx.doi.org/10.1016/j.chest.2017.08.005

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    2018-07-24 Smile2680
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    2018-03-05 循证小兵
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    2018-02-20 whlxd
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1721662, encodeId=69d11e2166286, content=<a href='/topic/show?id=39d6915e9bf' target=_blank style='color:#2F92EE;'>#诊断价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91579, encryptionId=39d6915e9bf, topicName=诊断价值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7c7d33065043, createdName=medscijoin, createdTime=Sat Jan 27 10:02:00 CST 2018, time=2018-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929400, encodeId=0d58192940084, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Jul 24 14:02:00 CST 2018, time=2018-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1715697, encodeId=a1cf1e15697bf, content=<a href='/topic/show?id=8d0f1e691b5' target=_blank style='color:#2F92EE;'>#tPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17691, encryptionId=8d0f1e691b5, topicName=tPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6d2632003894, createdName=循证小兵, createdTime=Mon Mar 05 09:02:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647797, encodeId=2ca8164e7972d, content=<a href='/topic/show?id=a0d954329f' target=_blank style='color:#2F92EE;'>#CTP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5432, encryptionId=a0d954329f, topicName=CTP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab3223492864, createdName=whlxd, createdTime=Tue Feb 20 22:02:00 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050814, encodeId=23fd205081469, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Nov 18 21:02:00 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251067, encodeId=5919125106efe, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sun Aug 20 06:02:00 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625207, encodeId=59a8162520ed9, content=<a href='/topic/show?id=244e543344' target=_blank style='color:#2F92EE;'>#CTPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5433, encryptionId=244e543344, topicName=CTPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccfc20693700, createdName=chenhongpeng, createdTime=Sun Aug 20 06:02:00 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234775, encodeId=69a7234e75d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Fri Aug 18 15:22:29 CST 2017, time=2017-08-18, status=1, ipAttribution=)]
    2017-08-20 chenhongpeng
  8. [GetPortalCommentsPageByObjectIdResponse(id=1721662, encodeId=69d11e2166286, content=<a href='/topic/show?id=39d6915e9bf' target=_blank style='color:#2F92EE;'>#诊断价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91579, encryptionId=39d6915e9bf, topicName=诊断价值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7c7d33065043, createdName=medscijoin, createdTime=Sat Jan 27 10:02:00 CST 2018, time=2018-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929400, encodeId=0d58192940084, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Jul 24 14:02:00 CST 2018, time=2018-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1715697, encodeId=a1cf1e15697bf, content=<a href='/topic/show?id=8d0f1e691b5' target=_blank style='color:#2F92EE;'>#tPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17691, encryptionId=8d0f1e691b5, topicName=tPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6d2632003894, createdName=循证小兵, createdTime=Mon Mar 05 09:02:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647797, encodeId=2ca8164e7972d, content=<a href='/topic/show?id=a0d954329f' target=_blank style='color:#2F92EE;'>#CTP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5432, encryptionId=a0d954329f, topicName=CTP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab3223492864, createdName=whlxd, createdTime=Tue Feb 20 22:02:00 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050814, encodeId=23fd205081469, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Nov 18 21:02:00 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251067, encodeId=5919125106efe, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sun Aug 20 06:02:00 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625207, encodeId=59a8162520ed9, content=<a href='/topic/show?id=244e543344' target=_blank style='color:#2F92EE;'>#CTPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5433, encryptionId=244e543344, topicName=CTPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccfc20693700, createdName=chenhongpeng, createdTime=Sun Aug 20 06:02:00 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234775, encodeId=69a7234e75d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Fri Aug 18 15:22:29 CST 2017, time=2017-08-18, status=1, ipAttribution=)]
    2017-08-18 Jackie Li

    学习

    0