Chest CT Parameters to Predict the Major Adverse Events in Acute Submassive Pulmonary Embolism.

Tuberculosis and Respiratory Diseases

article

Jung, Sang Ku¹  Kim, Won Young¹  Lee, Choong Wook²  Seo, Dong Woo¹  Lee, Youn Sun¹  Lee, Jae Ho¹  Oh, Bum Jin¹  Kim, Won¹  Lim, Kyoung Soo¹  Hong, Sang Bum³  Lim, Chae Man³  Koh, Younsuck³ 

[1] Departments of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine;Departments of Radiology, Asan Medical Center, University of Ulsan College of Medicine;Departments of Respiratory and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine

关键词: Pulmonary Embolism;    Tomography;    Prognosis;   

DOI  :  10.4046/trd.2010.69.3.184

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

BACKGROUND The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). METHODS: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). RESULTS: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis (36.4+/-8.0 vs. 41.7+/-7.4, p<0.01; 45.7+/-9.4 vs. 41.5+/-7.6, p<0.01), superior vena cava diameter (19.2+/-3.4 vs. 18.0+/-3.4, p=0.02), azygos vein diameter (10.0+/-2.2 vs. 9.2+/-2.3, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE (1.34+/-0.48 vs. 1.03+/-0.28, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62~0.79). CONCLUSION: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.

【 授权许可】

CC BY-NC