Prediction of short term outcome of pulmonary embolism: Parameters at 16 multi-detector CT pulmonary angiography

Abstract

Purpose: To evaluate the accuracy of computed tomography pulmonary angiography (CTPA) parameters, for predicting short-term mortality in patients with acute pulmonary embolism (PE). Materials and methods: Thirty-two patients with proven PE had CT pulmonary angiography were included in the study. The clot burden using the Qanadli score (QS), and the right ventricular dysfunction (RVD) parameters were assessed on CT by calculating right ventricular/left ventricular (RV/LV) diameter ratios, interventricular septum abnormality, inferior vena cava contrast reflux, azygous vein and superior vena cava measures. Contrast density in pulmonary artery and descending aorta was evaluated for all patients. Patients were followed up for 30 days and then classified as survivors or non survivors. Results: Thirty-two patients were included in the study, 23 (71.8%) of them were classified as survivors, and the other nine (28.1%) patients died within the first month (non survivors). There was a positive, but weak correlation between the Qanadli score and the short term mortality (P value = 0.05). There was a statistically significant relationship between the RV/LV ratio and PE-related mortality, with a P value 18 according to the Qanadli score and to a lesser degree the interventricular septum abnormality.

Keywords

• Pulmonary embolism
• CT pulmonary angiography
• IVC reflux