Document Detail


Computed tomography for the detection of free-floating thrombi in the right heart in acute pulmonary embolism.
MedLine Citation:
PMID:  20809126     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to assess the prevalence of free-floating thrombi in the right heart (FFT) and the accuracy of computed tomography (CT) for their detection in pulmonary embolism (PE).
METHODS: We studied 340 consecutive patients presenting with PE. All patients underwent CT and echocardiography.
RESULTS: The prevalence of FFT was 3.5% in the global population of PE and 22% in high-risk PE. Dyspnoea, cardiogenic shock, cardiac arrest and tachycardia were more frequently found in patients with FFT (p = 0.04, p < 0.0001, p = 0.0003 and p = 0.01, respectively). Sensitivity and specificity of CT for the detection of FFT were 100% (95% confidence interval: 74%-100%) and 97% (95%-99%), whereas positive and negative predictive values were 57% (34%-78%) and 100% (99%-100%). Among patients with FFT, right ventricular dilation was always detected by CT, whereas no right ventricular dilation was found among patients with a false diagnosis of FFT performed by CT (p < 0.0001).
CONCLUSION: Prevalence of FFT is 3.5% and differs according to the clinical presentation. Detection of FFT by CT is feasible and should lead to echocardiography being promptly performed for the confirmation of FFT.
Authors:
Nicolas Mansencal; David Attias; Vincent Caille; Julien Desperramons; Julie Guiader; Mostafa El Hajjam; Pascal Lacombe; Imad Abi Nasr; François Jardin; Antoine Vieillard-Baron; Olivier Dubourg
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Publication Detail:
Type:  Journal Article     Date:  2010-08-31
Journal Detail:
Title:  European radiology     Volume:  21     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  240-5     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Université de Versailles-Saint Quentin (UVSQ), Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence des Maladies Cardiaques Héréditaires, Boulogne, France, nicolas.mansencal@apr.aphp.fr.
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