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Predictive value of perfusion defects on dual energy CTA in the absence of thromboembolic clots.

Abstract：

BACKGROUND:To determine the predictive value of volumetrically measured lung perfusion defects (PDvol) and right ventricular dysfunction on dual-energy computed tomography angiography (DE-CTA) for predicting all cause mortality in patients suspected of pulmonary embolism (PE) but without evident thromboembolic clot on CTA. METHODS:448 patients underwent DE-CTA on a 64-channel DSCT system between January 2007 and December 2012 for suspected PE, of which 115 were without detectable thromboembolic clot on CTA. Diagnostic performance for identifying patients at risk of dying was evaluated using ROC analysis. All-cause mortality was assessed via the hospital electronic medical records and/or consultation of the patient or the patient's primary care physician via phone call interviews. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve (AUC) were determined for PDvol (volume of perfusion defects/total lung volume), transverse right ventricular to left ventricular diameter ratios (RV/LV) and for the combination of both tests. RESULTS:Mortality was 38% within the investigated time period of 6 months. Patients who died had significantly higher PDvol (PDvol 28 ± 13% vs. 19 ± 12%, p < 0.001) and a non-significant difference in transverse RV/LV ratio (1.14 ± 0.37 vs. 1.06 ± 0.22, p = 0.159). The AUC was 0.71 for PDvol, 0.53 for RV/LV ratio, and 0.67 for the combination of PDvol and RV/LV ratio. PDvol remained a significant predictor after correcting for age. CONCLUSIONS:In the absence of thromboembolic clots, PDvol at DE-CTA appears to be predictive for all cause mortality.

journal_name

J Cardiovasc Comput Tomogr

journal_title

Journal of cardiovascular computed tomography

authors

Takx RAP,Henzler T,Schoepf UJ,Germann T,Schoenberg SO,Shirinova A,Bauer RW,Frellesen C,Zhang LJ,Nance JW,Fink C,Apfaltrer P

doi

10.1016/j.jcct.2017.04.005

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

183-187

issue

3

eissn

1934-5925

issn

1876-861X

pii

S1934-5925(17)30092-8

journal_volume

11

pub_type

杂志文章,多中心研究

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