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Vol. 24. Issue 8.
Pages 335-340 (November 2000)
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Vol. 24. Issue 8.
Pages 335-340 (November 2000)
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Concordancia entre los hallazgos obtenidos mediante la arteriografía pulmonar, la radiología de tórax, la tomografía computarizada y la broncoscopia en enfermos con hemoptisis graves
Concordance between bronchial arteriography, chest radiology, computer tomography and bronchoscopy in patients with serious haemoptysis
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A.C. Nebra puertas*,1, C. Puebla macarrón**, M.T. Rosell abós***, B. Virgós señor*, J. Fernández gómez**, J. Medrano peña**, M.A. De gregorio ariza**
* Servicios de Medicina Intensiva
** Radiología
*** Neumología. Hospial Clínico Universitario Lozano Blesa. Zaragoza
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Fundamento

La hemoptisis significativa es un problema clínico frecuente y grave. El objetivo del presente trabajo era comparar los hallazgos obtenidos mediante las diferentes técnicas diagnósticas empleadas en estos casos.

Pacientes y métodos

Fueron incluidos 40 pacientes ingresados en el Hospital Clínico de Zaragoza por hemoptisis significativas, y a los que se realizó una arteriografía bronquial (AB) selectiva. Se utilizaron como técnicas diagnósticas la fibrobroncoscopia (FB), la radiografía simple de tórax (RT) y la tomografía computarizada (TC), tomándose y comparándose los hallazgos más significativos para cada una de las técnicas y empleándose la AB como referencia; se utiliza el coeficiente Kappa como método de validación interobservadores para cada una de las pruebas radiológicas y se calcula el cociente de probabilidades como indicador de calidad diagnóstica de las distintas pruebas.

Resultados

La RT es una buena técnica diagnóstica con determinadas imágenes. La TC guarda una buena fiabilidad diagnóstica con determinados patrones radiológicos; por el contrario la FB obtuvo en nuestra serie peores resultados de los esperados.

Conclusiones

La RT es la primera técnica diagnóstica a realizar por su sencillez, bajo coste y por la información que aporta con determinados patrones. Respecto a la TC, guarda una elevada correlación de manera global. La FB presenta, pese a unos resultados pobres en nuestra serie a la hora de localizar el punto sangrante, la ventaja de poder realizar toma de muestras y maniobras terapeúticas en determinadas situaciones.

Palabras Clave:
hemoptisis
técnicas diagnósticas
radiografía de tórax
fibrobroncoscopia
tomografía computarizada arteriografía bronquial
Background

Haemoptysis is a serious and frequent clinical problem. The goal of our study was to make a comparision between the different diagnostic techniques.

Patients and methods

We included 40 patients admitted to our Hospital for significant haemoptysis; all of them were explored with bronchial arteriography (BA), thorax roentengenogram (TR), computer tomography (CT) and fibrobronchoscopy (FB), taking the more significant pictures for each technique and using BA as the reference gold standard. Kappa coeficient and likelihood ratio are calculated.

Results

TR is a good technique with determinated patterns. TC had good diagnostic reliability with some patterns; on the other hand, FB had poorer than expected results.

Conclusions

TR is the first technique to be done, it is easy and cheap and gives important information with determinated patterns. TR has a high correlation with TC. FB has, in our patients, poor results regarding localization of the bleeding point; on the other hand, it allows us to take a biopsy or microbiology samples.

Key words:
Haemoptysis
diagnostic techniques
torax roentengenogram
computer tomography
fibrobronchoscopy
bronchial arteriography
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Copyright © 2000. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
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Medicina Intensiva (English Edition)

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