Purpose
INTRODUCTION:
Pulmonary CT angiography is the gold standard techniquefor the diagnosis of acute pulmonary embolism (APE).
There are severalsigns to asses severity of APE with CT beingimportant for ensuring optimal patient care and predictingembolism outcoming.
Among the scales that determine severity,
the next parameters are frequently meassure: Left Ventricular Diameter (LVD),
Right-Left Ventricular Ratio (RLVR),
Main Pulmonary Artery Diameter (PD) and Qanadli scale.
Qanadli scale quantifies the CTA obstruction score and it is controversial,
however,
whether it is a predictorof right ventricule failure and poor...
Methods and Materials
30 patients who underwent DECTA with the diagnosis of APE were retrospectively reviewed (19 women,
11 men; mean age: 70 y.o.).
Patients with other concomitant pulmonary pathology or chest disease that could interfere with iodine maps were excluded.
Left Ventricular Diameter (LVD),
Right-Left Ventricular Ratio (RLVR),
Main Pulmonary artery Diameter (PD) and Qanadli scale were measured as severity CT predictor factorsin all patients.
The aplication “Lung PBV” and the tool "Lung Isolation" of Siemens softwareCT was used to automathically calculate: (Fig.4 ,
Fig.5,
Fig.6)
average...
Results
Average enhancement for total lung parenchyma was 25,60 ± 10,87 HU and relative enhacement: 78,88 ± 24,29.
Statistically significant correlation was found between average enhancement and Qanadli severity index (p=0,013).
There were no significant correlations between quantitative values of enhancement in iodine maps and other CT severity markers.
Fig.7.
Conclusion
Iodine lung perfusion maps are correlated with Qanadli CT scale in patients with APE.
Correlation with other CT severityparameters was not found.
References
1.-Eun Jin Chae,
Joon Beom Seo,
Yu Mi Jang,
Bernhard Krauss,
Choong Wook Lee,
Hyun Joo Lee,
et al.
Dual-Energy CT for Assessment of the Severity of Acute Pulmonary Embolism: Pulmonary Perfusion Defect Score Compared With CT Angiographic Obstruction Score and Right Ventricular/Left Ventricular Diameter Ratio.
AJR March 2010 194:604-610.
2.-Sven F.
Thieme,
Thorsten R.
C.
Johnson, Christopher Lee,
Justin McWilliams,
Christoph R.
Becker,
Maximilian F.
Reiser,
et al.
Dual-Energy CT for the Assessment of Contrast Material Distribution in the Pulmonary Parenchyma.
AJR July 2009...
