Mehmet Mahir Atasoy1, Nesrin Sariman, Ender Levent, Rahmi Çubuk, Ömer Çelik, Attila Saygi, Işil Atasoy, Sinan Şahin. 1. From the *Departments of Radiology and †Respiratory Disease, Maltepe University School of Medicine; ‡Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; and §Departments of Cardiology and ║Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Abstract
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 to mortality. 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.
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 to mortality. 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.
Authors: A Carmona-Bayonas; M Sánchez-Cánovas; J M Plasencia; A Custodio; E Martínez de Castro; J A Virizuela; F Ayala de la Peña; P Jiménez-Fonseca Journal: Clin Transl Oncol Date: 2017-06-07 Impact factor: 3.405
Authors: Mads Dam Lyhne; Jacob Gammelgaard Schultz; Peter J MacMahon; Faris Haddad; Mannudeep Kalra; David Mai-King Tso; Alona Muzikansky; Michael H Lev; Christopher Kabrhel Journal: Emerg Radiol Date: 2019-08-02