RT Journal Article
SR Electronic
T1 Evaluation of acute pulmonary embolism by sixty-four slice multidetector CT angiography: Correlation between obstruction index, right ventricular dysfunction and clinical presentation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3746
DO 10.1183/13993003.congress-2015.PA3746
VO 46
IS suppl 59
A1 Noha Attia
A1 Gehan Seifeldein
A1 Ali Hasan
A1 Abdelkarim Hasan
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA3746.abstract
AB Background: The severity of acute pulmonary embolism (PE) as estimated by the clot burden, obstruction index (OI) as well as right ventricular dysfunction (RVD) can be evaluated using multidetector CT (MDCT) pulmonary angiography.Objective: To investigate the correlation between the MDCT OI, RVD and clinical status in patients with acute PE.Methods: Seventy patients proved to have PE using 64-slice MDCT underwent full medical history and clinical examination. The clot burden in the pulmonary vascular tree was quantified using the established and validated Qanadli score and the OI which is a scoring system based on the site of obstruction and the degree of pulmonary arteries occlusion was calculated. RVD was evaluated using MDCT and was considered present if the RV/LV diameter using the four-chamber view of the heart > 1 and pulmonary artery diameter > 2.9mm. The best cut-off for the OI to detect the presence of RVD was constructed using ROC curve.Results: The mean OI was 35% ± 16%. It was significantly higher in patients with dyspnea, tachypnea and hypotension. The mean OI was also significantly higher in patients with RVD (P <0.001). A positive correlation was found between the OI and both the CT pulmonary artery diameter (r=0.661, P<0.001) and the RV/LV diameter ratio (r=0.628, P<0.001). A CT OI >43% identified more than 90% of patients with RVD (area under the curve on ROC analysis: 0.825; p <0.001).Conclusion: The mean OI correlated linearly with RVD and an OI >43% proved to be an independent predictor of worse clinical status and RVD in patients with acute PE.