Document Detail


Reproducibility of CT signs of right ventricular dysfunction in acute pulmonary embolism.
MedLine Citation:
PMID:  20489089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of our study was to determine the interobserver reproducibility of CT findings of right ventricular (RV) dysfunction in pulmonary embolism (PE). MATERIALS AND METHODS: Two experienced observers independently and retrospectively evaluated pulmonary CT angiography (CTA) studies of 50 patients with acute PE for the following signs: bowing of the interventricular septum, inferior vena cava (IVC) contrast medium reflux, RV diameter (RVD)/left ventricular diameter (LVD) ratio on axial sections and four-chamber (4-CH) views, and RV volume (RVV)/left ventricular volume (LVV) ratio. Analysis used kappa statistics, Spearman's rank correlation, and Bland-Altman statistics. RESULTS: The two observers had fair to moderate agreement (kappa = 0.32-0.44) for septal bowing and moderate to good agreement (kappa = 0.57-0.68) for diagnosing IVC reflux. The Spearman's rank correlation coefficients for RVD(axial)/LVD(axial) ratio and RVD(4-CH)/LVD(4-CH) ratio between the two observers were 0.88 (p < 0.001) and 0.85 (p < 0.001), respectively. On Bland-Altman analysis, the mean differences for RVD(axial)/LVD(axial) ratio and RVD(4-CH)/LVD(4-CH) ratio were 0.014 (+/- 0.195) and 0.001 (+/- 0.242), respectively. The correlation coefficient for RVV/LVV ratio was 0.93 (p < 0.001), and the mean difference was 0.033 (+/- 0.229). CONCLUSION: Considerable differences exist in the interobserver reproducibility of CT findings of RV dysfunction on pulmonary CTA in patients with acute PE. Cardiac chamber measurements are more reproducible than septal bowing and IVC reflux. Volumetric determination of the RVV/LVV ratio is the least user dependent and most reproducible.
Authors:
Doo Kyoung Kang; Luis Ramos-Duran; U Joseph Schoepf; Andrew M Armstrong; Joseph A Abro; James G Ravenel; Christian Thilo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  194     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1500-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Contrast Media
Coronary Angiography / methods*
Electrocardiography
Female
Humans
Iohexol / analogs & derivatives,  diagnostic use
Male
Pulmonary Embolism / complications*,  radiography*
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Retrospective Studies
Tomography, X-Ray Computed / methods*
Ventricular Dysfunction, Right / etiology*,  radiography*
Chemical
Reg. No./Substance:
0/Contrast Media; 66108-95-0/Iohexol; 73334-07-3/iopromide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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