Diagnosis of pulmonary embolism with various imaging modalities.
Diagnosis of pulmonary embolism with various imaging modalities.
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DOI：
10.1053/j.semvascsurg.2004.03.001
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发表时间：
2004-06-01
影响因子：
2.5
通讯作者：
Greenfield, Lazar J
中科院分区：
文献类型：
--
作者：
Srivastava, Sunita D;Eagleton, Matthew J;Greenfield, Lazar J
肺栓塞（PE）是一个主要的健康问题，每年影响大约600，000名新患者。PE的诊断可能很难做出，并且已经开发了一些成像研究来帮助这个过程。初步评估包括采集胸片。然而，放射学检查的结果往往是非特异性的。肺动脉造影历来是金标准研究，自数字减影技术实施以来，诊断率不断提高。这是一种侵入性手术，但是，主要并发症的发生率很低。已经开发出侵入性较小的模式，包括通气-灌注肺扫描。这些被用作评估疑似PE患者的初始筛选试验之一。高概率扫描的存在通常表明PE的存在，尽管很少有患者进行高概率扫描。该测试受到潜在肺部疾病或既往PE的显著影响。鉴于此，通气-灌注肺扫描作为评价疑似PE的主要诊断工具受到限制。螺旋计算机断层扫描（CT）目前作为PE的诊断工具受到广泛关注。目前，一项评估其疗效的前瞻性多中心试验（PIOPED II）已经启动，但结果尚未公布。初步报告表明，螺旋CT和静脉期CT可能成为患者评估的第一线研究。PE的诊断具有挑战性，目前使用几种成像方式来帮助临床医生。目前，通常需要多种方式来进行诊断。随着新技术的出现和成像技术的改进，PE的诊断将变得更加容易。
Pulmonary embolism (PE) is a major health concern that affects approximately 600,000 new patients annually. The diagnosis of PE can be difficult to make, and several imaging studies have been developed to aid in this process. Initial evaluation involves the acquisition of a chest radiograph. Findings on radiography, however, are often non-specific. The gold-standard study historically has been pulmonary angiography, with increasing diagnostic yield since the implementation of digital subtraction technology. This is an invasive procedure, however, but the incidence of major complications is low. Less invasive modalities have been developed and include ventilation-perfusion lung scans. These are used as one of the initial screening tests in evaluation of patients with suspected PE. The presence of a high-probability scan usually indicates the presence of a PE, although few patients have high probability scans. The test is significantly affected by underlying pulmonary disease or previous PE. Given this, ventilation-perfusion lung scans are limited as a primary diagnostic tool in the evaluation of suspected PE. Helical computed tomography (CT) is currently under much scrutiny as a diagnostic tool for PE. Currently a prospective, multicenter trial evaluating its efficacy (PIOPED II) has been initiated, but the results are pending. Preliminary reports suggest the helical CT and venous phase CT may become a first line study in patient evaluation. The diagnosis of PE is challenging and several imaging modalities are currently used to assist the clinician. Currently, multiple modalities are often required to make the diagnosis. With the advent of new technology and improved imaging techniques, the diagnosis of PE will become easier.