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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections.
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A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections.

机译：临床检查和计算机断层扫描对深颈部感染的前瞻性，盲法比较。

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OBJECTIVES/HYPOTHESIS: To determine whether there is a scientific basis for the routine use of contrast-enhanced computed tomography (CECT) in the evaluation of suspected deep neck infection (DNI). STUDY DESIGN: We conducted a prospective, blinded comparison of clinical examination and CECT in DNI. METHODS: Thirty-five consecutive patients with suspected DNI were prospectively assessed by clinical examination and CECT for the presence and extent of surgically drainable purulent collections. Before CECT a surgeon recorded clinical data and predicted the extent of infection. A head and neck neuroradiologist, blinded to the clinical evaluation, predicted the extent of infection based on CECT. Final outcome (the presence of a purulent collection) was determined at surgery or in long-term follow-up. The clinical and CECT findings were compared with the final outcome to determine the sensitivity, specificity, and accuracy of each modality. RESULTS: Twenty patients had purulent drainable collections. The accuracy of clinical examination alone in identifying a drainable collection was 63%, the sensitivity was 55%, and the specificity was 73%. The accuracy of CECT alone was 77%, the sensitivity was 95%, and the specificity 53%. When CECT and clinical examination were combined, the accuracy in identifying a drainable collection was 89%, the sensitivity was 95%, and the specificity 80%. If fluid collections with volumes of 2 mL or greater on CECT were considered, the accuracy of CECT would have been 85%, the sensitivity 89%, and the specificity 80%. CONCLUSION: CECT and clinical examination are both critical components in the evaluation of suspected DNI.
机译：目的/假设：确定在评估可疑深颈部感染（DNI）中常规使用造影剂计算机断层扫描（CECT）是否有科学依据。研究设计：我们对DNI中的临床检查和CECT进行了前瞻性，盲法比较。方法：通过临床检查和CECT对35例疑似DNI的连续患者进行前瞻性评估，以评估是否存在可手术引流性化脓物。在进行CECT之前，外科医生记录了临床数据并预测了感染的程度。一位不愿接受临床评估的头颈神经放射科医生根据CECT预测了感染的程度。在手术或长期随访中确定最终结局（脓性集合的存在）。将临床和CECT结果与最终结果进行比较，以确定每种方法的敏感性，特异性和准确性。结果：20例患者有脓性可引流性收集物。仅临床检查在确定可引流收集物中的准确性为63％，敏感性为55％，特异性为73％。仅CECT的准确性为77％，敏感性为95％，特异性为53％。当将CECT和临床检查相结合时，可引流收集物的识别准确度为89％，敏感性为95％，特异性为80％。如果考虑使用CECT收集体积为2 mL或更大的液体，则CECT的准确度应为85％，灵敏度为89％，特异性为80％。结论：CECT和临床检查都是评估可疑DNI的关键因素。

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