title: Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome.
abstract: 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.
  
  
  CONCLUSIONS
  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.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
authors.forename: Ralf W
authors.initials: RW
authors.lastname: Bauer
authors.forename: Claudia
authors.initials: C
authors.lastname: Frellesen
authors.forename: Matthias
authors.initials: M
authors.lastname: Renker
authors.forename: Boris
authors.initials: B
authors.lastname: Schell
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehnert
authors.forename: Hanns
authors.initials: H
authors.lastname: Ackermann
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.forename: Volkmar
authors.initials: V
authors.lastname: Jacobi
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: J Matthias
authors.initials: JM
authors.lastname: Kerl
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016279:Atrial Function, Left / Q000502:physiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D016001:Confidence Intervals; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006334:Heart Function Tests; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011652:Pulmonary Circulation / Q000502:physiology; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging* / Q000401:mortality*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016278:Ventricular Function, Right / Q000502:physiology
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D