Accuracy of the chest radiograph to identify bilateral pulmonary infiltrates consistent with the diagnosis of acute respiratory distress syndrome using computed tomography as reference standard
Accuracy of the chest radiograph to identify bilateral pulmonary infiltrates consistent with the diagnosis of acute respiratory distress syndrome using computed tomography as reference standard
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DOI：
10.1016/j.jcrc.2012.12.002
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发表时间：
2013-08-01
影响因子：
3.7
通讯作者：
Ayyappan, Anoop P.
中科院分区：
文献类型：
--
作者：
Figueroa-Casas, Juan B.;Brunner, Noemi;Ayyappan, Anoop P.
目的：本研究的目的是评估前后位胸片的诊断准确性，以检测与急性呼吸窘迫综合征 (ARDS) 相符的肺部异常。材料和方法：确定了 90 名符合 ARDS 标准的患者，无论其影像学如何，并且几乎同时进行了胸片和计算机断层扫描 (CT)。这些放射学研究由 2 名放射科医生使用既定的放射学标准盲目独立地审查是否存在与 ARDS 一致的双侧肺部异常。分歧以协商一致方式解决。以胸部CT判读为参考标准，计算胸片诊断参数。结果：灵敏度（Se）为0.73；特异性，0.70；阳性和阴性预测值分别为0.88和0.47。女性与较高的 Se 和较低的特异性相关。当通过CT根据疾病分布对患者进行分类时，局灶性的Se明显低于弥漫性的。结论：便携式胸片检测符合ARDS的肺部异常的准确性明显有限。这些发现表明，胸部X光片的使用主要导致对该综合征的识别不足，特别是当疾病没有广泛分布时，但也会导致过度诊断。 (C) 2013 Elsevier Inc. 保留所有权利。
Purpose: The purpose of the study is to evaluate the diagnostic accuracy of the anteroposterior chest radiograph to detect pulmonary abnormalities consistent with acute respiratory distress syndrome (ARDS).Materials and methods: Ninety patients who met criteria for ARDS regardless of the radiographic one and had near simultaneous chest radiograph and computed tomography (CT) performed were identified. These radiologic studies were reviewed blindly and independently by 2 radiologists for the presence or absence of bilateral pulmonary abnormalities consistent with ARDS using defined radiologic criteria. Disagreements were resolved by consensus. Using the chest CT interpretation as reference standard, the chest radiograph diagnostic parameters were calculated.Results: Sensitivity (Se) was 0.73; specificity, 0.70; positive and negative predictive values were 0.88 and 0.47, respectively. Female sex was associated with higher Se and lower specificity. When patients were divided according to disease distribution by CT, the Se was significantly lower for focal as compared with diffuse.Conclusions: The accuracy of the portable chest radiograph to detect pulmonary abnormalities consistent with ARDS is significantly limited. These findings suggest that the use of the chest radiograph results mainly in underrecognition of the syndrome, particularly when disease is not diffusely distributed, but also in overdiagnosis. (C) 2013 Elsevier Inc. All rights reserved.