Correlation between gallium lung scans and fiberoptic bronchoscopy in patients with suspected Pneumocystis carinii pneumonia and the acquired immune deficiency syndrome.
Correlation between gallium lung scans and fiberoptic bronchoscopy in patients with suspected Pneumocystis carinii pneumonia and the acquired immune deficiency syndrome.
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疑似卡氏肺孢子虫肺炎患者的镓肺扫描和纤维支气管镜检查与获得性免疫缺陷综合征之间的相关性。
DOI：
10.1164/arrd.1984.130.6.1166
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Murray,JF
中科院分区：
文献类型：
--
作者：
Coleman,DL;Hattner,RS;Luce,JM;Dodek,PM;Golden,JA;Murray,JF
我们回顾了22例已知或疑似获得性免疫缺陷综合征患者的镓肺扫描检测卡氏肺孢子虫肺炎的敏感性和特异性。支气管镜检查结果与使用简单系统(正常或异常)和分级评分(1至4)解释的镓扫描结果之间存在相关性。12例肺孢子虫病患者均有异常扫描(敏感度为100%)。这12名患者中有5名动脉血氧饱和度和/或胸部X线片正常。在10例无肺孢子虫的患者中，使用简单系统扫描有8例异常(特异性，20%)，而使用分级系统只有1例异常(特异性，90%)。5名肺孢子虫肺炎患者在治疗后进行了扫描和支气管镜检查；两种解释方法都与微生物的存在有关。我们的结论是：(1)对于可疑的肺孢子虫肺炎患者，镓扫描是一项敏感的初步诊断试验；(2)分级评分系统提高了特异性；(3)对于可疑的肺孢子虫肺炎患者，镓扫描异常(3或更高)是一种活组织检查的指征，即使PO2和/或胸片正常。
We retrospectively examined the sensitivity and specificity of gallium lung scans for detectingPneumocystis cariniipneumonia in 22 patients with known or suspected acquired immune deficiency syndrome. Correlations were made between bronchoscopic results and gallium scan findings interpreted using a simple system (normal or abnormal) and a graded score (1 to 4). All 12 patients withPneumocystishad abnormal scans by both interpretations (sensitivity, 100%). Five of these 12 patients had normal arterial PO2values, chest roentgenograms, or both. In the 10 patients withoutPneumocystis, scans were read as abnormal in 8 using the simple system (specificity, 20%) but were abnormal in only 1 using the grading system (specificity, 90%). Five patients withPneumocystispneumonia had scans and bronchoscopy after treatment; neither method of interpretation correlated with the presence of organisms. We conclude: (1) gallium scanning is a sensitive initial diagnostic test in patients with suspectedPneumocystispneumonia; (2) a graded scoring system improves specificity; (3) an abnormal gallium scan (3 or greater) in patients with suspectedPneumocystispneumonia is an indication for biopsy, even when the PO2and/or chest roentgenogram are normal.