Keywords:
Pulmonary vessels, CT, CT-Angiography, Computer Applications-Detection, diagnosis, Embolism / Thrombosis
Authors:
S. Tan, A. Gupta; Perth, WA/AU
DOI:
10.26044/ranzcr2021/R-0039
Methods and materials
Retrospective single centre review of all patients admitted to the intensive care unit (ICU) with admission diagnosis of pulmonary embolism from 1st January 2015 to 30th September 2016 (total of 38 patients). 14 patients were excluded due to inaccurate diagnosis, lack of access to external imaging, and diagnosis by other imaging modalities. The remainder 24 patients (study group) were classified as the patients with massive PE, which is defined as PE with obstructive shock (SBP <90mmHg).
A control group of 25 patients were randomly picked from patients with positive CT pulmonary angiogram (CTPA) studies performed in our institution during the same period who did not require ICU admission. These patients were classified as having submassive PE (with right ventricular dysfunction without obstructive shock).
Basic demographic and clinical data for both groups were obtained. A range of measurements were made on CT pulmonary angiogram (1.5mm thick slices), including representative density of the embolus (with separate measurements for each distinct embolus), septal wall and left ventricular (LV) wall density, and diameter of the right (RV) and left ventricles. Further volumetric measurements were made using Siemens syngo.via program, with which we obtained overall volume and average density of pulmonary emboli. From these measurements, RV: LV ratio was calculated.