Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III).
Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III).
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DOI：
10.7326/0003-4819-152-7-201004060-00008
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发表时间：
2010-04-06
影响因子：
39.2
通讯作者：
PIOPED III (Prospective Investigation of Pulmonary Embolism Diagnosis III) Investigators
中科院分区：
文献类型：
--
作者：
Stein PD;Chenevert TL;Fowler SE;Goodman LR;Gottschalk A;Hales CA;Hull RD;Jablonski KA;Leeper KV Jr;Naidich DP;Sak DJ;Sostman HD;Tapson VF;Weg JG;Woodard PK;PIOPED III (Prospective Investigation of Pulmonary Embolism Diagnosis III) Investigators
钆增强磁共振肺血管造影和磁共振静脉造影诊断肺栓塞的准确性尚未最终确定。探讨磁共振血管造影（有或无磁共振静脉造影）诊断肺栓塞的性能特点。2006年4月10日至2008年9月30日的前瞻性、多中心研究。（ClinicalTrials.gov注册号：NCT 00241826）7家医院及其急救服务。371例确诊或排除肺栓塞的成人。通过将独立读取的磁共振成像与诊断肺栓塞的参考标准进行比较，测量灵敏度、特异性和似然比。通过使用各种检查（包括计算机断层血管造影和静脉造影、通气-灌注肺扫描、静脉超声检查、D-二聚体测定和临床评估）进行参考标准诊断或排除。各中心平均的磁共振血管造影术在25%的患者（371例中的92例）中技术不充分。在不同的中心，技术不充分的图像比例从11%到52%不等。包括技术上不充分的图像，磁共振血管造影确定57%（59/104）的肺栓塞。技术上充分的磁共振血管造影的敏感性为78%，特异性为99%。技术上充分的磁共振血管造影术和静脉造影术的敏感性为92%，特异性为96%，但52%的患者（370例中的194例）技术上不充分。高比例的疑似栓塞患者不合格或拒绝参加。磁共振肺动脉造影应该只在常规检查良好的中心进行，并且只适用于标准检查禁忌的患者。磁共振肺动脉造影和磁共振静脉造影联合使用在技术上足够的图像的患者中比单独的磁共振肺动脉造影具有更高的灵敏度，但这两种程序更难以获得技术上足够的图像。国家心肺血液研究所。
The accuracy of gadolinium-enhanced magnetic resonance pulmonary angiography and magnetic resonance venography for diagnosing pulmonary embolism has not been determined conclusively. To investigate performance characteristics of magnetic resonance angiography, with or without magnetic resonance venography, for diagnosing pulmonary embolism. Prospective, multicenter study from 10 April 2006 to 30 September 2008. (ClinicalTrials.gov registration number: NCT00241826) 7 hospitals and their emergency services. 371 adults with diagnosed or excluded pulmonary embolism. Sensitivity, specificity, and likelihood ratios were measured by comparing independently read magnetic resonance imaging with the reference standard for diagnosing pulmonary embolism. Reference standard diagnosis or exclusion was made by using various tests, including computed tomographic angiography and venography, ventilation–perfusion lung scan, venous ultra-sonography, D-dimer assay, and clinical assessment. Magnetic resonance angiography, averaged across centers, was technically inadequate in 25% of patients (92 of 371). The proportion of technically inadequate images ranged from 11% to 52% at various centers. Including patients with technically inadequate images, magnetic resonance angiography identified 57% (59 of 104) with pulmonary embolism. Technically adequate magnetic resonance angiography had a sensitivity of 78% and a specificity of 99%. Technically adequate magnetic resonance angiography and venography had a sensitivity of 92% and a specificity of 96%, but 52% of patients (194 of 370) had technically inadequate results. A high proportion of patients with suspected embolism was not eligible or declined to participate. Magnetic resonance pulmonary angiography should be considered only at centers that routinely perform it well and only for patients for whom standard tests are contraindicated. Magnetic resonance pulmonary angiography and magnetic resonance venography combined have a higher sensitivity than magnetic resonance pulmonary angiography alone in patients with technically adequate images, but it is more difficult to obtain technically adequate images with the 2 procedures. National Heart, Lung, and Blood Institute.
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影响因子：
5
作者：
Ohno, Y;Higashino, T;Sugimura, K
通讯作者：
Sugimura, K
影响因子：
6.7
作者：
Blum, A;Bellou, A;Wahl, D
通讯作者：
Wahl, D
影响因子：
6.7
作者：
Krishnam, Mayil S.;Tomasian, Anderanik;Ruehm, Stefan G.
通讯作者：
Ruehm, Stefan G.
DOI：
10.2214/ajr.04.1814
发表时间：
2006-07-01
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Kluge, Alexander;Luboldt, Wolfgang;Bachmann, Georg
通讯作者：
Bachmann, Georg
影响因子：
5
作者：
Ersoy, Hale;Goldhaber, Samuel Z.;Rybicki, Frank
通讯作者：
Rybicki, Frank