Ultrasonography by emergency physicians in patients with suspected cholecystitis
Ultrasonography by emergency physicians in patients with suspected cholecystitis
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DOI：
10.1053/ajem.2001.20028
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发表时间：
2001-01-01
影响因子：
3.6
通讯作者：
Wolfe, RE
中科院分区：
文献类型：
--
作者：
Rosen, CL;Brown, DFM;Wolfe, RE
本文调查了急诊医生（EP）使用床旁腹部超声（BAU）筛查患者胆石症和胆囊炎的情况。在这项前瞻性研究中，EP对116例患者进行了BAU。应用Kappa统计量分析BAU与放射科常规腹部超声（FUS）诊断胆石症和胆囊炎的一致性，计算BAU诊断胆石症和急性胆囊炎的试验特征。在胆石症和急性胆囊炎中，BAU和FUS的一致性分别为0.71和0.46。BAU诊断胆石症的敏感性为92%，特异性为78%，阳性预测值（PPV）为86%，阴性预测值（NPV）为88%。BAU诊断急性胆囊炎的敏感性为91%，特异性为66%，阳性预测值为70%，阴性预测值为90%，BAU可排除胆石症，对胆囊炎敏感。然而，当经验有限的EP识别胆囊炎时，在胆囊切除术前需要进行确认性试验（Am J Emerg Med 2001;19：32-36）。Copyright（C）2001 by W.B.桑德斯公司）。
This article investigates the use of bedside abdominal ultrasonography (BAU) performed by emergency physicians (EPs) to screen patients for cholelithiasis and cholecystitis. In this prospective study EPs performed BAU on 116 patients. Agreement between BAU and formal abdominal ultrasound (FUS) performed in the radiology department for detecting cholelithiasis and cholecystitis was determined using Kappa statistics, Test characteristics of BAU for detecting cholelithiasis and acute cholecystitis were calculated. Agreement between BAU and FUS was 0.71 for cholelithiasis and 0.46 for acute cholecystitis. Test characteristics of BAU for cholelithiasis were sensitivity 92%, specificity 78%, positive predictive value (PPV) 86%, negative predictive value (NPV) 88%. Test characteristics of BAU for acute cholecystitis compared with clinical follow-up were sensitivity 91%, specificity 66%, PPV 70%, NPV 90%, BAU may be used to exclude cholelithiasis and is sensitive for cholecystitis. However, when EPs with limited experience identify cholecystitis a confirmatory test is warranted before cholecystectomy, (Am J Emerg Med 2001;19:32-36. Copyright (C) 2001 by W.B. Saunders Company).