Volumetric analysis of pulmonary CTA for the assessment of right ventricular dysfunction in patients with acute pulmonary embolism
Rationale and Objectives - To retrospectively determine the value of a volumetric ventricle analysis for the assessment of right ventricular dysfunction in patients with suspected pulmonary embolism (PE) by using image data from non-electrocardiographically (ECG)-gated multidetector computed tomogra...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[March 2010]
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| In: |
Academic radiology
Year: 2010, Volume: 17, Issue: 3, Pages: 309-315 |
| ISSN: | 1878-4046 |
| DOI: | 10.1016/j.acra.2009.10.022 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.acra.2009.10.022 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1076633209005947 
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| Author Notes: | Thomas Henzler, Radko Krissak, Miriam Reichert, Tim Sueselbeck, Stefan O. Schoenberg, Christian Fink |
| Summary: | Rationale and Objectives - To retrospectively determine the value of a volumetric ventricle analysis for the assessment of right ventricular dysfunction in patients with suspected pulmonary embolism (PE) by using image data from non-electrocardiographically (ECG)-gated multidetector computed tomography angiography (CTA). - Materials and Methods - Hypothesizing that the presence of PE and the embolus location correlated with right ventricular dysfunction, we retrospectively analyzed 100 non-ECG-gated pulmonary CTA datasets of patients with central, peripheral, and without PE. Right ventricle/left ventricle (RV/LV) diameter ratio measured in transverse sections (RV/LVtrans), four-chamber view (RV/LV4ch), and RV/LV volume ratio (RV/LVvol) were assessed on CT images. The results were correlated with the embolus location, the 30-day mortality rate, and the necessity of intensive care treatment. - Results - All CT parameters showed statistically significant differences between all patients groups depended on embolus location. The receiver operating characteristic analysis RV/LVvol showed the strongest discriminatory power to differ between patients with central and without PE and between patients with central and peripheral PE (central PE vs. no PE: RV/LVvol = 0.932, RV/LVtrans = 0.880, and RV/LV4ch = 0.811, central PE vs. peripheral PE: RV/LVvol = 0.950, RV/LVtrans = 0.849, and RV/LV4ch = 0.881), indicating a correlation with embolus location predisposing for RVD. For the identification of high-risk patients with PE all three CT parameters showed statistically significant values (P < .0001), whereas in the receiver operating characteristic analysis, RV/LVvol had the strongest discriminatory power (RV/LVvol = 0.819, RV/LVtrans = 0.799, and RV/LV4ch = 0.758). - Conclusion - Ventricle volumetry of non-ECG-gated CTA allows the assessment of right ventricular dysfunction in patients with acute PE. Compared to unidimensional measurements, a volumetric analysis seems to be slightly superior to identify high-risk patients with adverse clinical outcome. However, the method is more time consuming and requires dedicated software tools compared to unidimensional parameters, which is disadvantageous in an emergency setting. |
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| Item Description: | Gesehen am 19.04.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1878-4046 |
| DOI: | 10.1016/j.acra.2009.10.022 |