沙特阿拉伯SCD患者与非SCD患者CT肺血管造影(CTPA)的定量评估。

Dunya Alfaraj, Hussain Alkhawaja, Mohannad Alghamdi, Zahraa Almuhanna, Iba Alfawaz, Abdulbary Alhalimi, Ali Aljazzar, Abdullah Bunaian, Hassan Almadan, Arwaa Haji, Abdullah Alamoudi, Fatimah Alfaraj, Yara Almazyad
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引用次数: 0

摘要

背景:镰状细胞病(SCD)是一种由β-珠蛋白基因突变引起的遗传性疾病,可导致全身性并发症,包括中风、缺血性坏死和急性胸综合征。该病在撒哈拉以南非洲、地中海和中东等地区最为流行,沙特阿拉伯各省的患病率和严重程度存在显著差异。目的:本研究的重点是比较SCD和非SCD患者的CT肺血管造影(CTPA)质量和肺栓塞(PE)诊断率,解决检测灵敏度和临床结果的差异。方法:我们对60名成年SCD患者和60名年龄匹配的对照组进行了回顾性比较,所有患者都在急诊科使用MDCT扫描仪对疑似PE进行了评估。数据,包括人口统计和临床信息,以及CT检查结果,都是从电子健康记录中提取的。结果:SCD患者CT肺血管造影阳性检出率为13.3%(8/60),非SCD匹配对照组为18.3%(11/60)。两组CTPA研究阳性率差异无统计学意义(p=0.453)。SCD患者肺动脉主动脉(PA)的增强(平均249.9 HU)明显低于对照组(平均283.7 HU) (p值= 0.043)。此外,SCD患者的血红蛋白水平显著降低(p值< 0.001)。结论:与接受CTPA的对照组相比,SCD患者在急性PE阳性率方面无显著差异。此外,SCD患者的主PA增强较低支持了CT血管造影在该人群中检测PE的敏感性降低的假设。质量改进计划应集中于个性化方案优化,以提高质量和增加确诊的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quantitative Assessment of CT Pulmonary Angiogram (CTPA) in SCD Patients in Comparison to non-SCD Cases in Saudi Arabia.

Background: Sickle cell disease (SCD) is a genetic disorder caused by a mutation in the β-globin gene, leading to systemic complications, including stroke, avascular necrosis, and acute chest syndrome. The disease is most prevalent in regions such as sub-Saharan Africa, the Mediterranean, and the Middle East, with Saudi Arabia showing significant variability in prevalence and severity across its provinces.

Objectives: This study focuses on comparing the quality of CT pulmonary angiography (CTPA) and the rates of pulmonary embolism (PE) diagnosis between SCD and non-SCD patients, addressing discrepancies in detection sensitivity and clinical outcomes.

Methods: We conducted a retrospective comparison between 60 adult SCD patients and 60 age-matched controls, all of whom were evaluated for suspected PE in our emergency department using an MDCT scanner. Data, including demographic and clinical information, as well as CT findings, were extracted from electronic health records.

Results: In SCD patients, the rate of positive CT pulmonary angiograms was 13.3% (8/60), while in non-SCD matched controls, it was 18.3% (11/60). There was no significant difference in the rate of positive CTPA studies (p=0.453). SCD patients exhibited significantly lower enhancement in the main pulmonary artery (PA) (mean 249.9 HU) compared to control subjects (mean 283.7 HU) (p-value= 0.043). Moreover, hemoglobin levels were notably lower in SCD patients (p-value < 0.001).

Conclusion: SCD patients demonstrated no significant difference in the rate of positive studies for acute PE when compared with controls undergoing CTPA. Furthermore, the lower main PA enhancement in SCD patients supports the hypothesis suggesting reduced sensitivity of CT angiography in detecting PE in this population. Quality improvement initiatives should concentrate on individualized protocol optimization to enhance enhancement quality and increase the likelihood of a definitive diagnosis.

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