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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Beyond the pulmonary arteries: alternative diagnoses in children with MDCT pulmonary angiography negative for pulmonary embolism.
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Beyond the pulmonary arteries: alternative diagnoses in children with MDCT pulmonary angiography negative for pulmonary embolism.

机译：肺动脉以外：MDCT肺血管造影对肺栓塞阴性的儿童的其他诊断。

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OBJECTIVE: A potential advantage of pulmonary CT angiography (CTA) is its ability to show alternative diagnoses in patients without evidence of pulmonary embolism (PE), but the frequency and spectrum of alternative diagnoses have yet to be determined in the pediatric population. Our purpose was to determine the frequency and types of alternative diagnoses identified in children with clinically suspected but excluded PE. MATERIALS AND METHODS: We used our hospital information system to identify all consecutive pediatric patients (< 18 years old) with clinically suspected PE who underwent pulmonary CTA from July 2004 to March 2008. Two experienced pediatric radiologists reviewed by consensus a series of 96 consecutive diagnostic-quality pulmonary CTA studies without evidence of PE from 89 patients. Each study was systematically reviewed by consensus for a possible alternative diagnosis in the lungs, mediastinum, central airways, cardiovascular system, pleura, and skeleton. RESULTS: The study population consisted of 89 children (28 boys and 61 girls; mean age 13.4 +/- 4.7 years; range, 2 months-18 years; 34 inpatients, 62 outpatients) who underwent a total of 96 pulmonary CTA studies without evidence of PE. Thirty-nine (41%) of 96 pulmonary CTA studies were normal. Alternative diagnoses were identified for each of the remaining 57 (59%) studies, including: pneumonia (n = 22), atelectasis (n = 22), malignancy (n = 3), congenital heart disease (n = 2), pulmonary hypertension (n = 2), pericardial effusion (n = 2), pulmonary nodules (n = 1), rib fractures (n = 1), right atrial thrombus (n = 1), and fat embolism (n = 1). Seventeen patients showed pleural effusions that were associated with coexisting pneumonia (n = 8), atelectasis (n = 8), or rib fractures (n = 1). CONCLUSION: Among children with clinically suspected but excluded PE, pulmonary CTA frequently shows positive findings. Although pneumonia and atelectasis are most common, a variety of other alternative diagnoses may be detected throughout the thorax.
机译：目的：肺CT血管造影（CTA）的潜在优势在于其能够在没有肺栓塞（PE）证据的患者中显示其他诊断，但是在儿科人群中尚需确定其他诊断的频率和范围。我们的目的是确定在临床上可疑但被排除的PE儿童中发现的替代诊断的频率和类型。材料与方法：我们使用我们的医院信息系统，确定了从2004年7月至2008年3月接受了肺部CTA检查的所有连续怀疑有临床怀疑PE的小儿患者（<18岁）。两名经验丰富的儿科放射科医生经一致评审了一系列96例连续诊断高质量的肺部CTA研究，没有89例PE的证据。通过共识系统地审查了每项研究，以寻找在肺，纵隔，中央气道，心血管系统，胸膜和骨骼方面的可能替代诊断。结果：研究人群包括89名儿童（无证据），共89例儿童（28例男孩和61例女孩;平均年龄13.4 +/- 4.7岁;范围：2个月至18岁; 34例住院患者，62例门诊患者）。 PE。 96例肺CTA研究中有39例（41％）正常。其余57项研究（59％）中的每一项均确定了其他诊断，包括：肺炎（n = 22），肺不张（n = 22），恶性肿瘤（n = 3），先天性心脏病（n = 2），肺动脉高压（n = 2），心包积液（n = 2），肺结节（n = 1），肋骨骨折（n = 1），右心房血栓（n = 1）和脂肪栓塞（n = 1）。 17名患者出现胸膜积液，并发肺炎（n = 8），肺不张（n = 8）或肋骨骨折（n = 1）。结论：在临床上怀疑但排除PE的儿童中，肺部CTA经常显示阳性结果。尽管肺炎和肺不张是最常见的，但在整个胸腔中仍可以检测到多种其他诊断方法。

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