Nonsevere Acute Pulmonary Embolism: Prognostic CT Pulmonary Angiography Findings

被引:12
|
作者
Atasoy, Mehmet Mahir [1 ]
Sariman, Nesrin [2 ]
Levent, Ender [2 ]
Cubuk, Rahmi [1 ]
Celik, Omer [3 ]
Saygi, Attila [2 ]
Atasoy, Isil [4 ]
Sahin, Sinan [5 ]
机构
[1] Maltepe Univ, Sch Med, Dept Radiol, TR-34844 Istanbul, Turkey
[2] Maltepe Univ, Sch Med, Dept Resp Dis, TR-34844 Istanbul, Turkey
[3] Mehmet Akif Ersoy Thorac & Cardiovasc Surg Traini, Dept Cardiol, Istanbul, Turkey
[4] Dr Siyami Ersek Thorac & Cardiovasc Surg Training, Dept Cardiol, Istanbul, Turkey
[5] Dr Siyami Ersek Thorac & Cardiovasc Surg Training, Dept Radiol, Istanbul, Turkey
关键词
pulmonary embolism; nonsevere; hemodynamically stable; computerized tomography pulmonary angiography; prognostic findings; RIGHT-VENTRICULAR DYSFUNCTION; INFERIOR VENA-CAVA; COMPUTED-TOMOGRAPHY; HELICAL CT; SEVERITY ASSESSMENT; OBSTRUCTION INDEX; PREDICTORS; ENLARGEMENT; MANAGEMENT; MORTALITY;
D O I
10.1097/RCT.0000000000000201
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To retrospectively evaluate the prognostic parameters of computed tomography (CT) pulmonary angiographic findings in nonsevere (hemodynamically stable) pulmonary embolism(PE) patients and to assess the predictive value of these parameters for mortality within 1 month of the initial diagnosis. Materials and Methods: Retrospectively, 67 consecutive patients (28 men, 39 women; mean age, 63.25 +/- 18 years) from 2 centers with nonsevere PE diagnosed using CT and a clinical evaluation were included in the current study. Using consensus reading, 2 readers blinded to the patients' clinical outcomes quantified the right ventricle short axis to left ventricle short axis ratio in the axial plane, vascular measurements, reflux of contrast medium into the inferior vena cava and azygos vein, ventricular septal bowing, and clot load using the Qanadli scoring system. The Simplified Pulmonary Embolism Severity Index (sPESI) and pulmonary parenchymal findings were also evaluated. All CT pulmonary angiographic parameters were compared with the risk of death within 1 month using logistic regression analysis. Results: Fifty-nine patients survived (88.1%), and 8 patients (11.9%) died because of PE. The sPESI and 2 parenchymal findings (multiple wedge-shaped opacities or consolidation accompanied by a wedge-shaped opacity) were significantly related tomortality. In the univariate analysis, neither the cardiovascular CT parameters nor the clot burden was significant between the survivors and nonsurvivors (P > 0.05). Conclusions: In clinically nonsevere PE patients, the sPESI and significant parenchymal findings were the CT parameters related to 1-month mortality.
引用
收藏
页码:166 / 170
页数:5
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