폐색전증에서 나선형 컴퓨터 전산화 단층촬영의 관찰자간의 일치도에 관한 연구
- Alternative Title
- A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism
- 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 $3.91{\pm}0.30$ (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."
- All Author(s)
- 김양기
; 이영목
; 김기업
; 어수택
; 김용훈
; 박춘식
; 황정화
; 김동훈
; 구동억
; 최득린
- Issued Date
- 2005
- Type
- Article
- Keyword
- Pulmonary Embolism; Spiral CT; Accordance between observers
- Publisher
- 대한결핵및호흡기학회
- ISSN
- 0378-0066
; 1738-3536
; 2005-6184
- Citation Title
- 결핵 및 호흡기질환
Tuberculosis and Respiratory Disease
- Citation Volume
- 59
- Citation Number
- 5
- Citation Start Page
- 473
- Citation End Page
- 479
- Language(ISO)
- kor
- DOI
- 10.4046/trd.2005.59.5.473
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/588
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