Severity assessment of pulmonary embolism using dual energy CT – correlation of a pulmonary perfusion defect score with clinical and morphological parameters of blood oxygenation and right ventricular failure

Abstract

A DE-based P-score correlates with a number of parameters of PE severity. It might be easier and faster to perform than some traditional CT scoring methods for vascular obstruction.

High-pitch Dual-source Computed Tomography Pulmonary Angiography in Freely Breathing Patients

“…Initial outcome studies suggest worse prognosis in acute PE with an increase in perfusion defect size. 22,23 Iodine mapping is not available with the high-pitch dualsource mode. However, to what extent these observations with dual-energy CTPA are going to alter the management of patients with PE is still subject to research and clinical evaluation.…”

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

“…Furthermore, our aim was to use the most widespread diagnostic modality, which is why we did not introduce the computer aided diagnosis system, which may influence the interobserver agreement [3]. Recently, interest in the application of dual-source CT for identification of PE severity has increased, also with assessment of time required for perfusion defect scoring, which appears to be less time-consuming than scoring of obstruction of pulmonary arteries [16].…”

Where do we stand? Functional imaging in acute and chronic pulmonary embolism with state-of-the-art CT

“…of Pages 6 correlates well with the endoluminal clot burden score determined by the Qanadli or Mastora indices. Further it correlates with RV strain determined by RV/LV ratios and it inversely correlates with arterial oxygen levels [40,41,44]. Although a growing amount of data suggests a potential prognostic role for DE obtained PBV imaging in PE patients, the added value of this measurement compared with conventional CTPA measurements of RV/LV ratios is inconclusive but is subject of ongoing evaluations [38,45].…”

“…Lung parenchyma iodine perfusion maps provide a quick and reader-independent tool for the quantitative assessment of pulmonary perfusion and strongly correlate with pulmonary perfusion scintigraphy and single-photon emission computed tomography (SPECT) images (Table 1) [36,37]. As expected, the numbers of DE CTPA have increased over the past years and scores for the assessment of perfusions defects on iodine distribution maps, which correlate with morphologic and clinical parameters of PE severity, have been developed [40,41]. However, a limitation of these perfusion scores is its high reader variability and its more time-consuming evaluation, which limits its clinical routine use.…”