title: Severity assessment of pulmonary embolism using dual energy CT - correlation of a pulmonary perfusion defect score with clinical and morphological parameters of blood oxygenation and right ventricular failure.
abstract: OBJECTIVE
  To correlate a Dual Energy (DE)-based visual perfusion defect scoring system with established CT-based and clinical parameters of pulmonary embolism (PE) severity.
  
  
  METHODS
  In 63 PE patients, DE perfusion maps were visually scored for perfusion defects (P-score). Vascular obstruction was quantified using the Mastora score. Both scores were correlated with short-axis diameters of the right and left ventricle, their ratio (RV/LV ratio), width of the pulmonary trunk, a number of clinical parameters and each other. Univariate and multivariate analyses were performed. Times to generate both scores were recorded.
  
  
  RESULTS
  After univariate and multivariate analysis, a significant (p < 0.05) correlation with the P-score was shown for the Mastora score (r = 0.65), RV/LV ratio (r = 0.47), width of the pulmonary trunk (r = 0.26), troponin I (r = 0.43) and PaO(2) (r = -0.50). For the left ventricular diameter, only univariate analysis showed a significant correlation. Mastora score correlated significantly with RV/LV ratio (r = 0.36), width of the pulmonary trunk (r = 0.27), PaO(2) (r = -0.41) and troponin I (r = 0.37). Mean time for generating the P-score was significantly shorter than for the Mastora score.
  
  
  CONCLUSIONS
  A DE-based P-score correlates with a number of parameters of PE severity. It might be easier and faster to perform than some traditional CT scoring methods for vascular obstruction.
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-Universität, Klinikum Großhadern, Marchioninistr.15, 81377 München, Germany. sven.thieme@med.uni-muenchen.de
authors.forename: Sven F
authors.initials: SF
authors.lastname: Thieme
authors.forename: Nima
authors.initials: N
authors.lastname: Ashoori
authors.forename: Fabian
authors.initials: F
authors.lastname: Bamberg
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
authors.forename: Thorsten R C
authors.initials: TR
authors.lastname: Johnson
authors.forename: Hanno
authors.initials: H
authors.lastname: Leuchte
authors.forename: Alexander
authors.initials: A
authors.lastname: Becker
authors.forename: Daniel
authors.initials: D
authors.lastname: Maxien
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Helck
authors.forename: Jürgen
authors.initials: J
authors.lastname: Behr
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
mesh_terms: D000368:Aged; D001769:Blood / Q000378:metabolism*; D002309:Cardiology / Q000379:methods*; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives / Q000494:pharmacology; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010477:Perfusion; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000378:metabolism*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D010100:Oxygen