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01.08.2014 | Original Article

The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism

verfasst von: Alpay Aribas, Suat Keskin, Hakan Akilli, Mehmet Kayrak, Halil Ibrahim Erdogan, Ibrahim Guler, Oguzhan Yildirim, Taha Tahir Bekci

Erschienen in: Japanese Journal of Radiology | Ausgabe 8/2014

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Abstract

Purpose

To evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE).

Materials and methods

A total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. RVD was assessed by echocardiography. The patients were divided into two groups based on the presence or absence of RVD.

Results

RV/LV ratio, SVC axial diameter, PA axial diameter, and Miller, Qanadli, and Mastora scores were significantly increased in the RVD group. Multivariate logistic regression analysis showed that RV/LV ratio [OR 6.36 (2.02–279.46 95 % CI), p = 0.01] and PA axial diameter [OR 5.02 (1.02–1.26 95 % CI), p = 0.03] were independent predictors of echocardiographic RVD. Predictive values of these parameters were improved when combined with other intragroup cutoff values. A cutoff value for the RV/LV ratio of >1.08 had 81.43 % sensitivity, 52.08 % specificity, 71.3 PPV, and 65.8 NPV for prediction of RVD.

Conclusion

Tomographic axial diameters enable more accurate predictions of RVD than OS scores do.

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Titel: The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism
verfasst von: Alpay Aribas
Suat Keskin
Hakan Akilli
Mehmet Kayrak
Halil Ibrahim Erdogan
Ibrahim Guler
Oguzhan Yildirim
Taha Tahir Bekci
Publikationsdatum: 01.08.2014
Verlag: Springer Japan
Erschienen in: Japanese Journal of Radiology / Ausgabe 8/2014
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-014-0327-8

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The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism