Multidetector-CT angiography in pulmonary embolism—can image parameters predict clinical outcome?

Heyer, C. M.; Lemburg, Stefan P.; Knoop, Heiko; Holland‐Letz, Tim; Nicolas, Volkmar; Roggenland, D.

doi:10.1007/s00330-011-2125-3

Cited by 29 publications

(32 citation statements)

References 40 publications

(59 reference statements)

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“…They observed abnormal shape of IVS in all patients with severe RVD; however, they defined RVD as an increased RV/LV ratio. A lack of correlation with mortality was also observed by Ghaye et al [5], who observed IVS bowing in 23% of survivors and 25% of non-survivors, or more recently by Moroni et al [12] and Heyer et al [7].…”

Section: Discussionmentioning

confidence: 60%

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Staśkiewicz

Czekajska−Chehab²,

Uhlig³

et al. 2013

Folia Morphol

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Bowing of the interventricular septum (IVS) is a sign of severe pulmonary embolism (PE); however, it is affected by high interobserver variability. The aim of the study was to evaluate the application of volumetric reconstructions of the right ventricle for assessment of IVS position regarding its accuracy in identifying right ventricular dysfunction, as well as interobserver agreement in evaluating this sign. IVS bowing was evaluated with multiplanar reformations (MPR) and volumetric reconstruction (VR, volume rendering) by 2 observers. The accuracy of IVS bowing sign was better for VR-based assessment; however, it was not significantly better than the MPR-based evaluation. Interobserver agreement was found to PE. (Folia Morphol 2013; 72, 2: 107-112)

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Section: Discussionmentioning

confidence: 60%

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Staśkiewicz

Czekajska−Chehab²,

Uhlig³

et al. 2013

Folia Morphol

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“…The assessment of severity of pulmonary embolism by CT pulmonary angiography has been studied for several years, and scores for pulmonary vessel obstruction have been developed 17,18 . Some studies found a significant relation between pulmonary clot score and mortality 19,20 but the others did not 15,18,21 . These findings suggest that not only pulmonary obstruction score but mainly subsequent right ventricular dysfunction determines the clinical outcome in patients with acute pulmonary embolism.…”

Section: Discussionmentioning

confidence: 99%

“…However, in multivariate analysis neither echocardiography nor CT parameters showed significant association with hypotension and/or tachycardia or blood biomarker levels. Heyer et al 15 found that acute pulmonary embolism can lead to increase in the RV CT/LV CT ratio. In a sample of 152 patients they measured a wide range 0.5 to 3.1 and the RV CT/LV CT ratio was also the only parameter to show a significant correlation with mortality in multivariate regression analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Multidetector CT pulmonary angiography is currently probably the most frequently used imaging technique for the diagnostics of acute pulmonary embolism 15,16 . The assessment of severity of pulmonary embolism by CT pulmonary angiography has been studied for several years, and scores for pulmonary vessel obstruction have been developed 17,18 .…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies these parameters were mainly analyzed: pulmonary artery/aorta ratio, right ventricular/left ventricular ratio, pulmonary obstruction index (POI), ventricular septal bowing (VSB) and venous contrast reflux (VCR) (ref. [12][13][14][15] ). In our study, we used pulmonary artery normalized diameter (nPA), PA/Ao ratio, RV CT/LV CT ratio in comparison with echocardiography parameters -normalized right ventricular diastolic diameter (nRV echo) and RV/LV diastolic diameter ratio (RVecho/LV echo).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the severity of acute pulmonary embolism using CT pulmonary angiography parameters

et al. 2015

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Aim. To evaluate the association between computed tomography parameters and clinical signs in patients with acute pulmonary embolism. Methods. 109 patients retrospectivelly selected from hospital database with acute pulmonary embolism verified by CT pulmonary angiography. The following parameters were assessed: pulmonary artery diameter to aorta diameter ratio (PA/Ao), normalized pulmonary artery diameter (nPA), right ventricular to left ventricular diameter ratio from CT (RV CT/LV CT), normalized end-diastolic right ventricular diameter (nRVD echo) and right to left ventricular end diastolic diameter ratio (RV echo/LV echo) from echocardiography. Conclusion.From the CT pulmonary angiography parameters, the RV CT/LV CT showed a significant association with both thrombolysis administration and ICU hospitalization. The PA/Ao had relation only to thrombolytic therapy as well as RV echo/LV echo only to ICU hospitalization.

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CHA₂DS₂‐VASc and PESI scores are associated with right ventricular dysfunction on computed tomography pulmonary angiography in patients with acute pulmonary thromboembolism

Alirezaei

Mahboubi-Fooladi

Irilouzadian

et al. 2022

Clinical Cardiology

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Background: Accurate risk stratification is the most important step in the management of patients with acute pulmonary thromboembolism (PTE). Pulmonary embolism severity index (PESI) is a clinical tool for PTE risk stratification. CHA 2 DS 2 -VASc score, a risk assessment tool in patients with atrial fibrillation, is recently considered for acute PTE. The presence of right ventricular (RV) dysfunction in imaging is more efficient in acute PTE risk evaluation. Hypothesis: This study aims to evaluate the association between CHA 2 DS 2 -VASc and PESI score and each of them with RV dysfunction on computed tomography pulmonary angiography (CTPA). Methods: One hundred eighteen patients with a definite diagnosis of PTE were entered. The CHA 2 DS 2 -VASc and PESI scores were calculated for all of them. RV dysfunction including an increase in RV to left ventricular diameter ratio, interventricular septal bowing, and reflux of contrast medium into the inferior vena cava was examined by CTPA. Results: PESI and CHA 2 DS 2 -VASc scores were significantly associated with RV dysfunction. In addition, different classes of PESI scores were correlated with RV dysfunction. Moreover, this study showed that the CHA 2 DS 2 -VASc score and PESI score had a positive correlation. The area under the curve value for the CHA 2 DS 2 -VASc score was 0.625 with 61.54% sensitivity and 60.0% specificity for predicting RV dysfunction while for PESI score was 0.635 with 66.7% sensitivity and 60.0% specificity. Conclusion: This study showed that not only CHA 2 DS 2 -VASc and PESI scores are positively correlated, but they are both associated with RV dysfunction diagnosed by CTPA. CHA 2 DS 2 -VASc and PESI scores are able to predict RV dysfunction.

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Multidetector-CT angiography in pulmonary embolism—can image parameters predict clinical outcome?

Abstract: Selected CTA findings showed significant associations with the clinical course of PE and may thus be used as predictive parameters.

Cited by 29 publications

References 40 publications

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Assessment of the severity of acute pulmonary embolism using CT pulmonary angiography parameters

CHA₂DS₂‐VASc and PESI scores are associated with right ventricular dysfunction on computed tomography pulmonary angiography in patients with acute pulmonary thromboembolism

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Multidetector-CT angiography in pulmonary embolism—can image parameters predict clinical outcome?

Abstract: Selected CTA findings showed significant associations with the clinical course of PE and may thus be used as predictive parameters.

Cited by 29 publications

References 40 publications

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Assessment of the severity of acute pulmonary embolism using CT pulmonary angiography parameters

CHA2DS2‐VASc and PESI scores are associated with right ventricular dysfunction on computed tomography pulmonary angiography in patients with acute pulmonary thromboembolism

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CHA₂DS₂‐VASc and PESI scores are associated with right ventricular dysfunction on computed tomography pulmonary angiography in patients with acute pulmonary thromboembolism