Chronic thromboembolism: Diagnosis with helical CT and MR imaging with angiographic and surgical correlation
Chronic thromboembolism: Diagnosis with helical CT and MR imaging with angiographic and surgical correlation
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DOI：
10.1148/radiology.204.3.9280245
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发表时间：
1997-09-01
期刊：
影响因子：
19.7
通讯作者：
Kapelanski, DP
中科院分区：
文献类型：
--
作者：
Bergin, CJ;Sirlin, CB;Kapelanski, DP
目的：评价螺旋计算机断层扫描（CT）和磁共振（MR）图像识别中枢性和节段性慢性血栓栓塞性疾病的准确性。材料与方法：分析55例疑似慢性血栓栓塞性肺动脉高压患者的影像学表现；其中包括血管造影（n = 55）、螺旋CT （n = 47）和MR成像（n = 26）的发现。40例患者行血栓动脉内膜切除术。CT和MR图像由两台读取器独立解读中央和节段性血管中血栓栓塞物质的存在。手术表现和血管造影表现分别是中央血管和节段性血管病变的参考标准。结果：螺旋CT扫描（每台阅读器的准确率为0.79）比血管造影（准确率为0.74）或磁共振成像（准确率分别为0.39和0.46）更准确地确定中央血管疾病。CT扫描（两个读卡器的准确率分别为0.75和0.76）比MR图像（两个读卡器的准确率分别为0.61和0.57）更准确地确定了节段性血管疾病。结论：螺旋CT是诊断慢性血栓栓塞的有效替代传统血管造影，但可能不足以在所有病例中选择手术候选人。
PURPOSE: To evaluate the accuracy of identification of central and segmental chronic thromboembolic disease on helical computed tomographic (CT) scans and on magnetic resonance (MR) images.MATERIALS AND METHODS: Radiologic findings in 55 patients suspected of having chronic thromboembolic pulmonary hypertension were analyzed; these included findings from angiography (n = 55), helical CT (n = 47), and MR imaging (n = 26). Forty patients underwent thromboendarterectomy. CT and MR images were independently interpreted by two readers for the presence of thromboembolic material in central and segmental vessels. Surgical findings and angiographic findings were the reference standards for disease in central and segmental vessels,respectively.RESULTS: Central vessel disease was determined more accurately with helical CT scans (accuracy of 0.79 for each of the two readers) than with angiograms (accuracy of 0.74) or with MR images (accuracy of 0.39 and 0.46 for two readers). Segmental vessel disease was also more accurately determined with CT scans (accuracy of 0.75 and 0.76 for two readers) than with MR images (accuracy of 0.61 and 0.57 for two readers).CONCLUSION: Helical CT is a useful alternative to conventional angiography for diagnosis of chronic thromboembolism but may not be sufficient for selecting candidates for surgery in all cases.