Relation between pulmonary embolus volume quantified by multidetector computed tomography and clinical status and outcome for patients with acute pulmonary embolism.
OBJECTIVE
The aim of this study was to determine whether pulmonary embolus volume (PEV) obtained with multi-detector row computed tomography is related to clinical status and outcomes.


METHODS
Subjects comprised 48 patients with acute pulmonary embolism (PTE). PEV was measured by tracing the contours manually and compared between sets of two groups divided by clinical status. Correlations of PEV to blood gases and D-dimer levels were investigated. PEV was tested as a predictor of clinical probability of acute PTE using Wells' criteria and as a predictor of survival after PTE by logistic regression analysis.


RESULTS
The PEV was greater in groups with respiratory symptoms (P < 0.001), PTE as pretest clinical diagnosis (P = 0.027), and heart rate >100 beats/min (P < 0.001). It was smaller in subjects with concurrent malignancy (P = 0.02). It was correlated with PaCO(2) (P = 0.04, rho = -0.37) and the D-dimer level (P = 0.002, rho = 0.46); it was not a predictor of clinical probability of acute PTE or survival after PTE. The survival rate did not differ between groups with PEV > 10 ml (8/9) or <or=10 ml (32/36).


CONCLUSIONS
The PEV in acute PTE may relate to the presence of respiratory symptoms, hypocapnia, and tachycardia. The PEV was smaller in patients with malignancy. It did not contribute to mortality in this study.
Nakada
Kei
K
Department of Radiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Japan. keinaka@saitama-med.ac.jp
Okada
Takemichi
T
Osada
Hisato
H
Honda
Norinari
N
D000208:Acute Disease; D000368:Aged; D001784:Blood Gas Analysis / Q000379:methods; D003287:Contrast Media; D005260:Female; D006304:Health Status; D006339:Heart Rate; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007472:Iohexol; D007479:Iopamidol; D008297:Male; D015588:Observer Variation; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012137:Respiratory System / Q000503:physiopathology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; D007479:Iopamidol