title: The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism.
abstract: OBJECTIVE
  To evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE).
  
  
  METHODS
  A total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. RVD was assessed by echocardiography. The patients were divided into two groups based on the presence or absence of RVD.
  
  
  RESULTS
  RV/LV ratio, SVC axial diameter, PA axial diameter, and Miller, Qanadli, and Mastora scores were significantly increased in the RVD group. Multivariate logistic regression analysis showed that RV/LV ratio [OR 6.36 (2.02-279.46 95 % CI), p = 0.01] and PA axial diameter [OR 5.02 (1.02-1.26 95 % CI), p = 0.03] were independent predictors of echocardiographic RVD. Predictive values of these parameters were improved when combined with other intragroup cutoff values. A cutoff value for the RV/LV ratio of >1.08 had 81.43 % sensitivity, 52.08 % specificity, 71.3 PPV, and 65.8 NPV for prediction of RVD.
  
  
  CONCLUSIONS
  Tomographic axial diameters enable more accurate predictions of RVD than OS scores do.
authors.affiliation: Department of Cardiology, Necmettin Erbakan University Meram School of Medicine Hospital, Meram, 42080, Konya, Turkey, draribas@hotmail.com.
authors.forename: Alpay
authors.initials: A
authors.lastname: Aribas
authors.forename: Suat
authors.initials: S
authors.lastname: Keskin
authors.forename: Hakan
authors.initials: H
authors.lastname: Akilli
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kayrak
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Erdogan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Guler
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Yildirim
authors.forename: Taha Tahir
authors.initials: TT
authors.lastname: Bekci
mesh_terms: D000208:Acute Disease; D000368:Aged; D001837:Body Weights and Measures / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide