Ventilation-perfusion-chest radiography match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent.
Ventilation-perfusion-chest radiography match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent.
复制标题
如果灌注减少而不是消失，通气-灌注-胸部X线摄影匹配不太可能代表肺栓塞。
DOI：
10.1097/00003072-200009000-00002
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发表时间：
2000
影响因子：
10.6
通讯作者：
Alavi,A
中科院分区：
文献类型：
--
作者：
Kim,CK;Worsley,DF;Alavi,A
目的作者的目的是确定具有匹配通气-灌注（V-Q）缺陷和胸部X线混浊的患者肺栓塞的患病率是否因灌注不足的程度（缺乏或减少）而不同。方法作者对肺栓塞诊断前瞻性调查（PIOPED）研究获得的数据进行了回顾性分析。在 233 名患者中，275 个肺区的血管造影具有诊断质量，显示匹配的 V-Q 缺损和胸部 X 线不透明度（三重匹配）。其中，检索并审查了 217 名患者的 255 个肺区三重匹配的 V-Q 扫描和胸片。根据共识，将与胸部放射线不透明相对应的区域评分为灌注减少或缺乏灌注。从 PIOPED 数据库中获得有关相应肺区是否存在肺栓塞的信息。结果所有三重匹配的肺区中肺栓塞的总体患病率为 27%（255 个肺区中的 69 个）。在三重匹配的 255 个区域中，153 个区域（60%）的灌注减少，102 个区域（40%）的灌注消失。在灌注减少的三重匹配区域和缺乏灌注的三重匹配区域，肺栓塞的发生率分别为 13%（153 例中的 20 例）和 48%（102 例中的 49 例）（卡方检验 P= 0.0001）。当按肺区进一步划分时，中上肺区灌注减少的三重匹配和缺乏灌注的三重匹配分别与 0%（44 人中的 0 人）和 25%（36 人中的 9 人）的患病率相关。下肺区灌注减少的三重匹配区域和缺乏灌注的三重匹配区域的肺栓塞患病率分别为 18%（109 人中的 20 人）和 61%（66 人中的 40 人）。结论如果灌注减少而不是缺乏，AV-Q/胸部放射学匹配不太可能代表肺栓塞。与所有肺区的所有三重匹配相关的肺栓塞的总体患病率从非常低（本系列中为 0%）到中等偏高（61%）不等，具体取决于灌注是否减少或缺乏以及三重匹配的位置。
PurposeThe authors’ goal was to determine whether the prevalence of pulmonary embolism in patients with matching ventilation–perfusion (V–Q) defects and chest radiographic opacities differs depending on the degree of perfusion deficit (absent versus decreased).MethodsThe authors performed a retrospective analysis of the data obtained from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. In 233 patients, angiograms were of diagnostic quality for 275 lung zones that showed matching V–Q defects and chest radiographic opacities (triple matches). Of these, V–Q scans and chest radiographs from 217 patients with triple matches in 255 lung zones were retrieved and reviewed. Areas corresponding to chest radiographic opacities were scored as having either decreased perfusion or absent perfusion by consensus. Information regarding the presence or absence of pulmonary embolism in corresponding lung zones was obtained from the PIOPED database.ResultsThe overall prevalence of pulmonary embolism in all lung zones with triple matches was 27%(69 of 255). Of the 255 areas of triple matches, the perfusion was decreased in 153 (60%) and absent in 102 (40%). The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion was 13%(20 of 153) and 48%(49 of 102), respectively (P= 0.0001 by the chi-square test). When these were divided further by lung zones, triple matches with decreased perfusion and triple matches with absent perfusion in the upper–middle lung zone were associated with a prevalence of 0%(0 of 44), and 25%(9 of 36), respectively. The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion in the lower lung zone was 18%(20 of 109), and 61%(40 of 66), respectively.ConclusionsAV–Q/chest radiographic match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. The overall prevalence of pulmonary embolism associated with all triple matches in all lung zones varied from very low (0% in this series) to upper intermediate (61%), depending on whether perfusion was decreased or absent and also on the location of the triple match.