OBJECTIVE: Acute massive pulmonary embolism causes abrupt pulmonary arterial hypertension and right ventricular dysfunction (RVD). Patients with RVD have a worse prognosis than those with normal right ventricular function. Consequently, recognizing the RVD at the time of pulmonary embolism is useful for risk stratification and enables more aggressive therapy. The study compared the accuracy of helical computed tomographic (CT) scans with echocardiography in the detecting of RVD in patients with acute massive pulmonary embolism. MATERIALS AND METHODS: Specifically, this work reviewed the CT pulmonary angiograms of 14 patients who were positive for acute massive pulmonary embolism during a 52-month period. CT scans were reviewed for findings indicating RVD. Scans were considered positive for RVD if the right ventricle was dilated or there was leftward shift of the interventricular septum. Echocardiographic reports serving as the reference standard for the diagnosis of RVD were also reviewed. CT study results were then correlated with echocardiography results. RESULTS: Among 14 patients with massive pulmonary embolism, echocardiography identified 12 patients having RVD, whereas the remaining two patients were negative for RVD. Meanwhile, CT correctly identified 11 of 12 patients as having RVD, and was negative for RVD in the remaining 3 patients. Correlated with echocardiography, CT scan for RVD detection had a sensitivity of 91.6% and a specificity of 100%. CONCLUSIONS: CT can accurately detect RVD in patients with acute massive pulmonary embolism. However, this result requires confirmation using a larger prospective cohort study.
OBJECTIVE: Acute massive pulmonary embolism causes abrupt pulmonary arterial hypertension and right ventricular dysfunction (RVD). Patients with RVD have a worse prognosis than those with normal right ventricular function. Consequently, recognizing the RVD at the time of pulmonary embolism is useful for risk stratification and enables more aggressive therapy. The study compared the accuracy of helical computed tomographic (CT) scans with echocardiography in the detecting of RVD in patients with acute massive pulmonary embolism. MATERIALS AND METHODS: Specifically, this work reviewed the CT pulmonary angiograms of 14 patients who were positive for acute massive pulmonary embolism during a 52-month period. CT scans were reviewed for findings indicating RVD. Scans were considered positive for RVD if the right ventricle was dilated or there was leftward shift of the interventricular septum. Echocardiographic reports serving as the reference standard for the diagnosis of RVD were also reviewed. CT study results were then correlated with echocardiography results. RESULTS: Among 14 patients with massive pulmonary embolism, echocardiography identified 12 patients having RVD, whereas the remaining two patients were negative for RVD. Meanwhile, CT correctly identified 11 of 12 patients as having RVD, and was negative for RVD in the remaining 3 patients. Correlated with echocardiography, CT scan for RVD detection had a sensitivity of 91.6% and a specificity of 100%. CONCLUSIONS: CT can accurately detect RVD in patients with acute massive pulmonary embolism. However, this result requires confirmation using a larger prospective cohort study.
Authors: Michael T Lu; Tianxi Cai; Hale Ersoy; Amanda G Whitmore; Noah A Levit; Samuel Z Goldhaber; Frank J Rybicki Journal: Int J Cardiovasc Imaging Date: 2008-07-15 Impact factor: 2.357
Authors: Paul D Stein; Fadi Matta; Abdo Y Yaekoub; Lawrence R Goodman; H Dirk Sostman; John G Weg; Charles A Hales; Russell D Hull; Kenneth V Leeper; Afzal Beemath; Ibrahim M Saeed; Pamela K Woodard Journal: J Thromb Thrombolysis Date: 2009-03-27 Impact factor: 2.300
Authors: Alexandru Marginean; Andrew Putnam; Taishi Hirai; Anthony Serritella; Stephanie A Besser; Margaret Lee; Janet Friant; John Blair; Atman Shah; Sandeep Nathan; Jonathan Chung; Jonathan Paul Journal: J Thromb Thrombolysis Date: 2020-07 Impact factor: 2.300
Authors: Paul D Stein; Afzal Beemath; Fadi Matta; Lawrence R Goodman; John G Weg; Charles A Hales; Russell D Hull; Kenneth V Leeper; H Dirk Sostman; Pamela K Woodard Journal: Am J Med Date: 2008-01 Impact factor: 4.965