Diagnostic accuracy and added value of dynamic chest radiography in detecting pulmonary embolism: A retrospective study

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  • 山崎, 誘三
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学
  • 細川, 和也
    九州大学大学医医学研究院臨床医学部門内科学講座循環器内科学
  • 神谷, 武志
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学
  • 阿部, 弘太郎
    九州大学大学医医学研究院臨床医学部門内科学講座循環器内科学
  • 鷺山, 幸二
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学
  • 日野, 卓也
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学
  • 池田, 恵
    九州大学大学院医学研究院
  • 西村, 俊輔
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学
  • 豊田, 広之
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学
  • 森山, 祥平
    九州大学大学院医学研究院
  • 河窪, 正照
    九州大学大学院医学研究院保健学部門
  • マツタニ, ノリツグ
    Healthcare Business Headquarters, KONICA MINOLTA, INC.
  • 藪内, 英剛
    九州大学大学院医学研究院保健学部門
  • 石神, 康生
    九州大学大学院医学研究院臨床医学部門内科学講座臨床放射線科学

書誌事項

公開日
2024-12
資源種別
journal article
権利情報
  • Creative Commons Attribution 4.0 International
  • © 2024 The Author(s).
DOI
  • 10.1016/j.ejro.2024.100602
公開者
Elsevier

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説明

Purpose / This study aimed to assess the diagnostic performance of dynamic chest radiography (DCR) and investigate its added value to chest radiography (CR) in detecting pulmonary embolism (PE). / Methods / Of 775 patients who underwent CR and DCR in our hospital between June 2020 and August 2022, individuals who also underwent contrast-enhanced CT (CECT) of the chest within 72 h were included in this study. PE or non-PE diagnosis was confirmed by CECT and the subsequent clinical course. The enrolled patients were randomized into two groups. Six observers, including two thoracic radiologists, two cardiologists, and two radiology residents, interpreted each chest radiograph with and without DCR using a crossover design with a washout period. Diagnostic performance was compared between CR with and without DCR in the standing and supine positions. / Results / Sixty patients (15 PE, 45 non-PE) were retrospectively enrolled. The addition of DCR to CR significantly improved the sensitivity, specificity, accuracy, and area under the curve (AUC) in the standing (35.6–70.0 % [P < 0.0001], 84.8–93.3 % [P = 0.0010], 72.5–87.5 % [P < 0.0001], and 0.66–0.85 [P < 0.0001], respectively) and supine (33.3–65.6 % [P < 0.0001], 78.5–92.2 % [P < 0.0001], 67.2–85.6 % [P < 0.0001], and 0.62–0.80 [P = 0.0002], respectively) positions for PE detection. No significant differences were found between the AUC values of DCR with CR in the standing and supine positions (P = 0.11) or among radiologists, cardiologists, and radiology residents (P = 0.14–0.68). / Conclusions / Incorporating DCR with CR demonstrated moderate sensitivity, high specificity, and high accuracy in detecting PE, all of which were significantly higher than those achieved with CR alone, regardless of scan position, observer expertise, or experience.

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