Keywords:
Cardiovascular system, Lung, Pulmonary vessels, CT-Angiography, Computer Applications-General, Computer Applications-Detection, diagnosis, Contrast agent-intravenous, Embolism / Thrombosis
Authors:
M. S. Fernández López-Peláez1, E. Zabía Galíndez2, M. J. Garcia Isidro2, E. Ayerbe Unzurrunzaga2; 1Madrid/ES, 2Boadilla del Monte, Madrid/ES
DOI:
10.1594/ecr2018/C-0890
Conclusion
Radiological risk stratification of patients with acute PE is very important because optimal management,
monitoring,
and therapeutic strategies depend on the prognosis.
In our study,
in patients with acute PE,
quantification of clot burden in PAs at MDCT did not show significant correlation with short or long term mortality at the follow-up; in most cases,
it was directly related with patient´s basal clinical status (underlying cancer disease).
However,
the highest clot burden MDCT scores showed strong correlation (p <0.05) with the presence of signs of right heart dysfunction (because of RV overload) in the male population,
and this correlation was more pronounced in the subgroup of patients with normal cardiorrespiratory reserve.
Finally,
patients with acute PE and signs of right heart dysfunction,
were found to have a strong significant correlation (p< 0.05) with the development of cardiopulmonary sequelae in the male population along the follow up.
We conclude that quantification of PA clot load still remains controversial for predicting prognosis in patients with acute PE.
Many other MDCT findings that may allow refinement of the risk stratification are still under evaluation.