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Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome.
MedLine Citation:
PMID:  21533631     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). METHODS: 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. RESULTS: D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. CONCLUSION: Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study.
Authors:
Ralf W Bauer; Claudia Frellesen; Matthias Renker; Boris Schell; Thomas Lehnert; Hanns Ackermann; U Joseph Schoepf; Volkmar Jacobi; Thomas J Vogl; J Matthias Kerl
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-30
Journal Detail:
Title:  European radiology     Volume:  -     ISSN:  1432-1084     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-5-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany, ralfwbauer@aol.com.
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