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

Authors
 Dong Jin Im  ;  Jin Hur  ;  Kyung Hwa Han  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Woocheol Kwon  ;  Byoung Wook Choi 
Citation
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.209(5) : 1015-1022, 2017 
Journal Title
AMERICAN JOURNAL OF ROENTGENOLOGY
ISSN
 0361-803X 
Issue Date
2017
MeSH
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
Keywords
DECT ; acute pulmonary embolism ; dual-energy CT ; lung perfusion ; ventricular diameter
Abstract
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.
Full Text
https://www.ajronline.org/doi/abs/10.2214/AJR.17.17815
DOI
10.2214/AJR.17.17815
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Im, Dong Jin(임동진) ORCID logo https://orcid.org/0000-0001-8139-5646
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161499
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