A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
;
: 473-479, 2005.
Article
Dans Coréen
| WPRIM
| ID: wpr-75633
ABSTRACT
BACKGROUND:
A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism.METHOD:
64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism".RESULTS:
The mean score of the patients according to the Wells method was 3.91 +/- 0.30 (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(kappa 0.83) in the main, 57.6%(kappa 0.63) in the lobar, 51.5%(kappa 0.63) in the segmental, and 34.6%(kappa 0.49) in the sub-segmental pulmonary arteries.CONCLUSION:
Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Artères
/
Artère pulmonaire
/
Embolie pulmonaire
/
Thorax
/
Thrombose
/
Tomodensitométrie
/
Tomodensitométrie hélicoïdale
/
Diagnostic
/
Retard de diagnostic
Type d'étude:
Etude diagnostique
/
Étude pronostique
Limites du sujet:
Humains
langue:
Coréen
Texte intégral:
Tuberculosis and Respiratory Diseases
Année:
2005
Type:
Article
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