Do CT pulmonary angiography features correlate with the pulmonary embolism severity index in patients with acute pulmonary embolism?
CT pulmonary angiography features, particularly obstruction index and dilated pulmonary trunk, correlate with clinical severity in acute pulmonary embolism as measured by PESI.
BACKGROUND: This study was conducted to detect the association between radiologic features of CT pulmonary angiography (CTPA) and pulmonary embolism severity index (PESI). METHODS: A total of 150 patients with a definite diagnosis of PE entered the study. The CTPA feature including obstruction index, pulmonary trunk size, presence of backwash contrast, septal morphology, right ventricular (RV) and left ventricular (LV) dimensions, and RV/LV ratio were examined. The severity of the PE was estimated using PESI. The association between CTPA indices and PESI was measured. Statistical analysis was conducted using the SPSS software. P value < 0.05 was considered as statistically significant. RESULTS: A positive correlation was detected between the obstruction index and PESI (r = 0.45, P < 0.05). Moreover, PESI was significantly higher in patients with a more dilated pulmonary trunk (r = 0.20, P < 0.05). The backwash contrast and abnormal septal morphology were significantly more common among patients with higher PESI (P < 0.05). However, no significant correlation was detected between RV, LV, RV/LV, and PESI. The most predictor of high-risk PE was dilated pulmonary trunk with an odds ratio of 4.4. CONCLUSION: Higher Obstruction index, dilated pulmonary trunk, presence of backwash contrast, and an abnormal septal morphology can be associated with a higher PESI.
Shayganfar et al. (Fri,) studied this question.