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Acute Pulmonary Embolism: Retrospective Cohort Study of the Predictive Value of Perfusion Defect Volume Measured With Dual-Energy CT

 Dong Jin Im  ;  Jin Hur  ;  Kyung Hwa Han  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Woocheol Kwon  ;  Byoung Wook Choi 
 American Journal of Roentgenology, Vol.209(5) : 1015-1022, 2017 
Journal Title
 American Journal of Roentgenology 
Issue Date
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Angiography* ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Pulmonary Circulation ; Pulmonary Embolism/diagnostic imaging* ; Pulmonary Embolism/mortality ; Pulmonary Embolism/therapy ; Retrospective Studies ; Tomography, X-Ray Computed* ; Treatment Outcome ; Young Adult
DECT ; acute pulmonary embolism ; dual-energy CT ; lung perfusion ; ventricular diameter
OBJECTIVE: The purposes of this study were to investigate dual-energy CT findings predictive of clinical outcome and to determine the incremental risk stratification benefit of dual-energy CT findings compared with CT ventricular diameter ratio in patients with acute pulmonary embolism. MATERIALS AND METHODS: A retrospective evaluation was conducted of the cases of 172 patients with acute pulmonary embolism who underwent dual-energy CT. Ventricular diameter ratio and relative perfusion defect volume were measured. The primary endpoints were death within 30 days and pulmonary embolism-related death. RESULTS: A ventricular diameter ratio of 1 or greater was associated with increased risk of death within 30 days (hazard ratio, 3.822; p = 0.002) and pulmonary embolism-related death (hazard ratio, 18.051; p < 0.001). Relative perfusion defect volume was also associated with increased risk of death of any cause within 30 days (hazard ratio, 1.044; p = 0.014) and pulmonary embolism-related death (hazard ratio, 1.046; p = 0.017). However, the addition of relative perfusion defect volume to ventricular diameter ratio had no added benefit for prediction of death of any cause within 30 days (concordance statistic, 0.833 vs 0.815; p = 0.187) or pulmonary embolism-related death (concordance statistic, 0.873 vs 0.874; p = 0.866). CONCLUSION: Compared with ventricular diameter ratio alone, lung perfusion defect volume had no statistically significant added benefit for prediction of death of any cause within 30 days or of pulmonary embolism-related death among patients with acute PE.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김영진(Kim, Young Jin)
이혜정(Lee, Hye Jeong)
임동진(Im, Dong Jin)
최병욱(Choi, Byoung Wook)
허진(Hur, Jin)
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