Volumetric analysis of pulmonary CTA for the assessment of right ventricular dysfunction in patients with acute pulmonary embolism

• Verfasst von: Henzler, Thomas [VerfasserIn]
• Verfasst von: Kriššák, Radko [VerfasserIn]
• Verfasst von: Reichert, Miriam [VerfasserIn]
• Verfasst von: Süselbeck, Tim [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Fink, Christian [VerfasserIn]
• Titel: Volumetric analysis of pulmonary CTA for the assessment of right ventricular dysfunction in patients with acute pulmonary embolism
• Verf.angabe: Thomas Henzler, Radko Krissak, Miriam Reichert, Tim Sueselbeck, Stefan O. Schoenberg, Christian Fink
• E-Jahr: 2010
• Jahr: [March 2010]
• Umfang: 7 S.
• Fussnoten: Gesehen am 19.04.2023
• Titel Quelle: Enthalten in: Academic radiology
• Ort Quelle: Philadelphia, PA [u.a.] : Elsevier, 1994
• Jahr Quelle: 2010
• Band/Heft Quelle: 17(2010), 3 vom: März, Seite 309-315
• ISSN Quelle: 1878-4046
• DOI: doi:10.1016/j.acra.2009.10.022
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Pulmonary embolism
• Sach-SW: right ventricular dysfunction
• Sach-SW: volumetric analysis
• K10plus-PPN: 1843140713

Abstract

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.