[en] Purpose: To retrospectively evaluate pulmonary artery (PA) clot load scores and computed tomographic (CT) cardiovascular parameters as predictors of mortality in patients with severe pulmonary embolism (PE). Materials and Methods: Institutional review board approval was obtained with waiver of informed consent. A total of 82 consecutive patients (42 women, 40 men; mean age +/- standard deviation, 61 years +/- 15) were admitted to the intensive care unit for PE-related conditions and were evaluated by using CT pulmonary angiography. Two independent readers who were blinded to clinical outcome quantified PA clot load by using four scoring systems. Cardiovascular measurements included right ventricular (RV) and left ventricular (LV) short-axis measurements; RV short axis to LV short axis (RV/LV) ratios; main PA, ascending aorta, azygos vein, and superior vena cava diameters; and main PA diameter to aorta diameter ratios. Reflux of contrast medium into the inferior vena cava, leftward bowing of the interventricular septum, pleural or pericardial effusion, pulmonary consolidation, infarct, platelike atelectasis, and mosaic ground-glass opacity were also recorded. Results were correlated with patient outcome during hospital stay by using the Wilcoxon rank sum and x(2) tests. Results: Twelve patients died within 1-14 days. RV and LV short axis; RV/LV ratio; azygos vein, superior vena cava, and aorta diameters; and contrast medium reflux into the inferior vena cava were significantly different between survivors and nonsurvivors (P <.05). No significant relationship was found between PA clot load and mortality rate. RV/LV ratio and azygos vein diameter allowed correct prediction of survival in 89% of patients (P <.001). Conclusion: RV/LV ratio and azygos vein diameter are predictors of mortality in patients with severe PE. (c) RSNA, 2006
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Ghaye, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > Imagerie médicale
Ghuysen, Alexandre ; Université de Liège - ULiège > Département des sciences de la santé publique > Réanimation - Urgence extrahospitalière
Willems, V.
Lambermont, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine
Gérard, Paul ; Université de Liège - ULiège > Département de mathématique > Statistique (aspects expérimentaux)
D'Orio, Vincenzo ; Université de Liège - ULiège > Département des sciences cliniques > Médecine d'urgence - bioch. et phys. hum. normales et path.
Gevenois, P. A.
Dondelinger, R. F.
Language :
English
Title :
Severe pulmonary embolism: Pulmonary artery clot load scores and cardiovascular parameters as predictors of mortality
Publication date :
June 2006
Journal title :
Radiology
ISSN :
0033-8419
eISSN :
1527-1315
Publisher :
Radiological Soc North America, Oak Brook, United States - Illinois
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