Acil Servise Başvuran Hastalarda Pulmoner Bt Anjiografi Tetkikinin Tanı Verimliliğinin Değerlendirilmesi

Evaluation of the Diagnostic Efficiency of Pulmonary Ct Angiography Examination at Emergency Department

Özet

Amaç: Acil servislerde ileri görüntüleme yöntemleri giderek artan oranlarda kullanılmaya başlamıştır. Bu hızlı artış beraberinde; hem söz konusu görüntüleme yöntemlerinin tanı verimliliğinin düşük olması olasılığını; hem de bu metotlara bağlı gelişebilecek olası zararları gündeme getirmiştir. Bu konuda acil servislerde pulmoner bilgisayarlı tomografi anjiografi (pulmoner BTA) kullanımı özellikle ön plana çıkmaktadır. Gereç ve Yöntemler: Çalışma, Ocak 2016 ile Haziran 2018 ayları arasında acil servise başvuran ve pulmoner emboli (PE) ön tanısı ile pulmoner BTA tetkiki istenen hastaların radyolojik görüntülerinin ve medikal kayıtlarının retrospektif olarak incelenmesi yöntemiyle yapıldı. Çalışma verileri SPSS 19 paket programı kullanılarak analiz edildi. Sayısal değişkenlerin karşılaştırmasında Mann Whitney U testi kategorik değişkenlerin karşılaştırmasında Ki-Kare testi kullanıldı. İstatistiksel verilerin yorumunda p

Abstract

Objective: The use of advanced medical imaging in the emergency department (ED) has increased substantially. With this rapid increase; the possibility of both the low diagnostic efficiency of these imaging methods; as well as the possible damages that may occur due to these methods came into question. In this regard, the use of pulmonary computed tomography angiography (pulmonary CTA), stands out. Material and Methods: After ethics committee approval this study was carried out by retrospectively examining the radiological images and medi- cal records of patients who were admitted to Çanakkale Onsekiz Mart University Emergency Department between January 2016 and June 2018, and for pulmonary CTA exam- ination was requested with a pre-diagnosis of PE. Study data were analyzed using SPSS 19 package program. Mann Whitney U test was used for comparison of numerical variables and Chi-Square test was used for comparison of categorical variables. In the interpretation of statistical data, p< 0.05 was considered significant. Results: In the study period, a total of 233 patients admitted to the emergency department and had pulmonary CTA with a pre-diagnosis of PE were identified. Eleven of the patients were excluded from the study because of artifacts. The data of the remaining 222 patients were analyzed. While pulmo- nary embolism was found in 19 (8.6%) patients (Group-1), pulmonary embolism was not found in 203 (91.4%) patients (Group-2). No pathology was observed in two (0.9%) of the patients without embolism and reported as normal. In both groups, the patients most frequently applied to the emergency department with complaints of shortness of breath and secondly, chest pain (Table-I). Conclusions: We found the diagnostic efficiency of pulmonary CTA is low (8.6%), consistent with the literature. However, we think that further studies are needed to increase the accuracy and performance of the examination.