Абугов писал(а):В медицинской части, мне, как ангиографисту (погрязшему в стентировании кор. артерий и прочих аорт), хотелось бы отметить, что диагностическая ценность МСКТ в визуализации мелких ветвей лёгочной артерии существенно выше, чем АПГ.
В подтверждение:
Published online before print September 11, 2007, 10.1148/radiol.2452070397
(Radiology 2007;245:315-329.)
Management of Suspected Acute Pulmonary Embolism in the Era of CT Angiography: A Statement from the Fleischner Society1
Martine Remy-Jardin, MD, PhD, Massimo Pistolesi, MD, Lawrence R. Goodman, MD, Warren B. Gefter, MD, Alexander Gottschalk, MD, John R. Mayo, MD, and H. Dirk Sostman, MD
1 From the Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037 Lille, France (M.R.); Respiratory Unit, Department of Critical Care, University of Florence, Florence, Italy (M.P.); Department of Radiology, Froedtert Memorial Lutheran Hospital, Milwaukee, Wis (L.R.G.); Department of Radiology, Hospital of the University of Pennsylvania; Philadelphia, Pa (W.B.G.); Department of Diagnostic Radiology, Michigan State University, East Lansing, Mich (A.G.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.R.M.); and Department of Radiology, New York Hospital–Cornell Medical Center, New York, NY (H.D.S.). Received February 28, 2007; revision requested March 28; revision received April 20; final version accepted June 6. Address correspondence to M.R. (e-mail:
mremy-jardin@chru-lille.fr).
INFLUENCE OF MULTIDETECTOR CT IN DIAGNOSIS OF ACUTE PE
Can Multidetector CT Replace Pulmonary Angiography as the Reference for Diagnosis of Acute PE?
What is the clinical validity of a negative multidetector CT scan? In a recent meta-analysis of 15 studies that used contrast material–enhanced chest CT to rule out the diagnosis of acute PE in a total of 3500 patients with a minimum of 3 months follow-up, Quiroz et al (16) reported that the clinical validity of using a CT scan to rule out PE is similar to that reported for conventional pulmonary angiography, namely 1.0%–2.8% for CT (including single-section, multidetector, and electron-beam CT) versus 1.1%–2.9% for conventional pulmonary angiography.
In addition to the direct visualization of clots on positive CT angiograms, the considerable advantage of CT over pulmonary angiography is that it can provide diagnostic information that is suggestive of either an alternative or an additional diagnosis.
In 2007, multidetector CT angiography has fulfilled the conditions to replace pulmonary angiography as the reference standard for diagnosis of acute PE.
