胸部正位X线片漏诊原因分析

The cause analysis of missed diagnosis of chest anteroposterior X-ray

目的回顾性分析、总结胸部正位X线片漏诊原因,以尽量减少胸部病变漏诊。方法利用PACS系统对我科近年胸部仅行正位X线片的患者重新阅片,部分病例与CT结果对比。结果确定漏诊病例33例,肺内病变16例,占48%(左肺门病变2例,左下肺野内带病变5例,右肺中叶肺不张3例,双膈下病变6例),纵隔病变3例,占9%,肺外病变14例,占42%(非骨折性肋骨病变6例,锁骨病变2例,肩胛骨病变2例,气管受压移位3例,右肱骨病变1例)。结论良好的阅片习惯、熟练掌握常见病发病部位、充分利用PACS后处理功能在一定程度上能够避免漏诊,提高诊断准确率。

Objective To try to reduce bosom lesions misdiagnosis through retrospective analysis and the summary of chest X-ray diagnosis reason. Methods We reread the slice of the patients who took only the line of the chest X-ray in recent years by using PACS in our department. We compared some cases with CT results to determine whether were the missed diagnosis. Results The missed diagnosis cases 33 cases, 16 cases of lung disease,48% （left lung door in 2 cases,lung dis- ease due to a wild with lesions in 5 cases, the middle of the atelectasis in 3 cases, 6 cases under the double diaphragm le- sions） ,mediastinal lesions in 3 cases （9%）,pulmonary lesions in 14 cases,42%（the fracture rib lesions of 6 cases, clavicle lesions in 2 cases,withers lesions in 2 cases,tracheal pressure shift in 3 cases,fight humerus lesions in 1 case. Conclu- sion Good habit of readding slice, master of common place, making full use of PACS post-processing function to some ex- tent are important to avoid misdiagnosis and improve the diagnostic accuracy.