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Published in: European Radiology 8/2007

01-08-2007 | Chest

Computed tomography pulmonary embolism index for the assessment of survival in patients with pulmonary embolism

Authors: Maciej Pech, Gero Wieners, Przemyslaw Dul, Frank Fischbach, Oliver Dudeck, Enrique Lopez Hänninen, Jens Ricke

Published in: European Radiology | Issue 8/2007

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Abstract

This study was an analysis of the correlation between pulmonary embolism (PE) and patient survival. Among 694 consecutive patients referred to our institution with clinical suspicion of acute PE who underwent CT pulmonary angiography, 188 patients comprised the study group: 87 women (46.3%, median age: 60.7; age range: 19–88 years) and 101 men (53.7%, median age: 66.9; age range: 21–97 years). PE was assessed by two radiologist who were blinded to the results from the follow-up. A PE index was derived for each set of images on the basis of the embolus size and location. Results were analyzed using logistic regression, and correlation with risk factors and patient outcome (survival or death) was calculated. We observed no significant correlation between the CTPE index and patient outcome (p = 0.703). The test of logistic regression with the sum of heart and liver disease or presence of cancer was significantly (p< 0.05) correlated with PE and overall patient outcome. Interobserver agreement showed a significant correlation rate for the assessment of the PE index (0.993; p< 0.001). In our study the CT PE index did not translate into patient outcome. Prospective larger scale studies are needed to confirm the predictive value of the index and refine the index criteria.
Literature
1.
go back to reference Meaney JF, Weg JG, Chenevert TL, Stafford-Johnson D, Hamilton BH, Prince MR (1997) Diagnosis of pulmonary embolism with magnetic resonance angiography. N Engl J Med 336(20):1422–1427PubMedCrossRef Meaney JF, Weg JG, Chenevert TL, Stafford-Johnson D, Hamilton BH, Prince MR (1997) Diagnosis of pulmonary embolism with magnetic resonance angiography. N Engl J Med 336(20):1422–1427PubMedCrossRef
2.
go back to reference Wildberger JE, Mahnken AH, Das M, Kuttner A, Lell M, Gunther RW (2005) CT imaging in acute pulmonary embolism: diagnostic strategies. Eur Radiol 15(5):919–929PubMedCrossRef Wildberger JE, Mahnken AH, Das M, Kuttner A, Lell M, Gunther RW (2005) CT imaging in acute pulmonary embolism: diagnostic strategies. Eur Radiol 15(5):919–929PubMedCrossRef
3.
go back to reference McEwan L, Gandhi M, Andersen J, Manthey K (1999) Can CT pulmonary angiography replace ventilation-perfusion scans as a first line investigation for pulmonary emboli? Australas Radiol 43(3):311–314PubMedCrossRef McEwan L, Gandhi M, Andersen J, Manthey K (1999) Can CT pulmonary angiography replace ventilation-perfusion scans as a first line investigation for pulmonary emboli? Australas Radiol 43(3):311–314PubMedCrossRef
4.
go back to reference Wu AS, Pezzullo JA, Cronan JJ, Hou DD, Mayo-Smith WW (2004) CT pulmonary angiography: quantification of pulmonary embolus as a predictor of patient outcome-initial experience. Radiology 230(3):831–835PubMedCrossRef Wu AS, Pezzullo JA, Cronan JJ, Hou DD, Mayo-Smith WW (2004) CT pulmonary angiography: quantification of pulmonary embolus as a predictor of patient outcome-initial experience. Radiology 230(3):831–835PubMedCrossRef
5.
go back to reference Goodman LR, Curtin JJ, Mewissen MW, Foley WD, Lipchik RJ, Crain MR et al (1995) Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. Am J Roentgenol 164(6):1369–1374 Goodman LR, Curtin JJ, Mewissen MW, Foley WD, Lipchik RJ, Crain MR et al (1995) Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. Am J Roentgenol 164(6):1369–1374
6.
go back to reference Drucker EA, Rivitz SM, Shepard JA, Boiselle PM, Trotman-Dickenson B, Welch TJ et al (1998) Acute pulmonary embolism: assessment of helical CT for diagnosis. Radiology 209(1):235–241PubMed Drucker EA, Rivitz SM, Shepard JA, Boiselle PM, Trotman-Dickenson B, Welch TJ et al (1998) Acute pulmonary embolism: assessment of helical CT for diagnosis. Radiology 209(1):235–241PubMed
7.
go back to reference Garg K, Welsh CH, Feyerabend AJ, Subber SW, Russ PD, Johnston RJ et al (1998) Pulmonary embolism: diagnosis with spiral CT and ventilation-perfusion scanning-correlation with pulmonary angiographic results or clinical outcome. Radiology 208(1):201–208PubMed Garg K, Welsh CH, Feyerabend AJ, Subber SW, Russ PD, Johnston RJ et al (1998) Pulmonary embolism: diagnosis with spiral CT and ventilation-perfusion scanning-correlation with pulmonary angiographic results or clinical outcome. Radiology 208(1):201–208PubMed
8.
go back to reference Mayo JR, Remy-Jardin M, Muller NL, Remy J, Worsley DF, Hossein-Foucher C et al (1997) Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology 205(2):447–452PubMed Mayo JR, Remy-Jardin M, Muller NL, Remy J, Worsley DF, Hossein-Foucher C et al (1997) Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology 205(2):447–452PubMed
9.
go back to reference Remy-Jardin M, Remy J, Deschildre F, Artaud D, Beregi JP, Hossein-Foucher C et al (1996) Diagnosis of pulmonary embolism with spiral CT: comparison with pulmonary angiography and scintigraphy. Radiology 200(3):699–706PubMed Remy-Jardin M, Remy J, Deschildre F, Artaud D, Beregi JP, Hossein-Foucher C et al (1996) Diagnosis of pulmonary embolism with spiral CT: comparison with pulmonary angiography and scintigraphy. Radiology 200(3):699–706PubMed
10.
go back to reference van Rossum AB, Pattynama PM, Ton ER, Treurniet FE, Arndt JW, van Eck B et al (1996) Pulmonary embolism: validation of spiral CT angiography in 149 patients. Radiology 201(2):467–470PubMed van Rossum AB, Pattynama PM, Ton ER, Treurniet FE, Arndt JW, van Eck B et al (1996) Pulmonary embolism: validation of spiral CT angiography in 149 patients. Radiology 201(2):467–470PubMed
11.
go back to reference Diffin DC, Leyendecker JR, Johnson SP, Zucker RJ, Grebe PJ (1998) Effect of anatomic distribution of pulmonary emboli on interobserver agreement in the interpretation of pulmonary angiography. Am J Roentgenol 171(4):1085–1089 Diffin DC, Leyendecker JR, Johnson SP, Zucker RJ, Grebe PJ (1998) Effect of anatomic distribution of pulmonary emboli on interobserver agreement in the interpretation of pulmonary angiography. Am J Roentgenol 171(4):1085–1089
12.
go back to reference Safriel Y, Zinn H (2002) CT pulmonary angiography in the detection of pulmonary emboli: a meta-analysis of sensitivities and specificities. Clin Imaging 26(2):101–105PubMedCrossRef Safriel Y, Zinn H (2002) CT pulmonary angiography in the detection of pulmonary emboli: a meta-analysis of sensitivities and specificities. Clin Imaging 26(2):101–105PubMedCrossRef
13.
go back to reference Qanadli SD, El Hajjam M, Vieillard-Baron A, Joseph T, Mesurolle B, Oliva VL et al (2001) New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. Am J Roentgenol 176(6):1415–1420 Qanadli SD, El Hajjam M, Vieillard-Baron A, Joseph T, Mesurolle B, Oliva VL et al (2001) New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. Am J Roentgenol 176(6):1415–1420
14.
go back to reference Patel S, Kazerooni EA, Cascade PN (2003) Pulmonary embolism: optimization of small pulmonary artery visualization at multi-detector row CT. Radiology 227(2):455–460PubMedCrossRef Patel S, Kazerooni EA, Cascade PN (2003) Pulmonary embolism: optimization of small pulmonary artery visualization at multi-detector row CT. Radiology 227(2):455–460PubMedCrossRef
15.
go back to reference Schoepf UJ, Helmberger T, Holzknecht N, Kang DS, Bruening RD, Aydemir S et al (2000) Segmental and subsegmental pulmonary arteries: evaluation with electron-beam versus spiral CT. Radiology 214(2):433–439PubMed Schoepf UJ, Helmberger T, Holzknecht N, Kang DS, Bruening RD, Aydemir S et al (2000) Segmental and subsegmental pulmonary arteries: evaluation with electron-beam versus spiral CT. Radiology 214(2):433–439PubMed
16.
go back to reference Brunot S, Corneloup O, Latrabe V, Montaudon M, Laurent F (2005) Reproducibility of multi-detector spiral computed tomography in detection of sub-segmental acute pulmonary embolism. Eur Radiol 15(10):2057–2063PubMedCrossRef Brunot S, Corneloup O, Latrabe V, Montaudon M, Laurent F (2005) Reproducibility of multi-detector spiral computed tomography in detection of sub-segmental acute pulmonary embolism. Eur Radiol 15(10):2057–2063PubMedCrossRef
17.
go back to reference Alpert JS, Smith R, Carlson J, Ockene IS, Dexter L, Dalen JE (1976) Mortality in patients treated for pulmonary embolism. JAMA 236(13):1477–1480PubMedCrossRef Alpert JS, Smith R, Carlson J, Ockene IS, Dexter L, Dalen JE (1976) Mortality in patients treated for pulmonary embolism. JAMA 236(13):1477–1480PubMedCrossRef
18.
go back to reference van der Meer RW, Pattynama PM, van Strijen MJ, van den Berg-Huijsmans AA, Hartmann IJ, Putter H et al (2005) Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3-month follow-up in patients with acute pulmonary embolism. Radiology 235(3):798–803PubMedCrossRef van der Meer RW, Pattynama PM, van Strijen MJ, van den Berg-Huijsmans AA, Hartmann IJ, Putter H et al (2005) Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3-month follow-up in patients with acute pulmonary embolism. Radiology 235(3):798–803PubMedCrossRef
19.
go back to reference Wildberger JE, Klotz E, Ditt H, Spuntrup E, Mahnken AH, Gunther RW (2005) Multislice computed tomography perfusion imaging for visualization of acute pulmonary embolism: animal experience. Eur Radiol 15(7):1378–1386PubMedCrossRef Wildberger JE, Klotz E, Ditt H, Spuntrup E, Mahnken AH, Gunther RW (2005) Multislice computed tomography perfusion imaging for visualization of acute pulmonary embolism: animal experience. Eur Radiol 15(7):1378–1386PubMedCrossRef
Metadata
Title
Computed tomography pulmonary embolism index for the assessment of survival in patients with pulmonary embolism
Authors
Maciej Pech
Gero Wieners
Przemyslaw Dul
Frank Fischbach
Oliver Dudeck
Enrique Lopez Hänninen
Jens Ricke
Publication date
01-08-2007
Publisher
Springer-Verlag
Published in
European Radiology / Issue 8/2007
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-007-0577-2

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