Article: article from journal or magazin.
Computed tomographic angiography in acute pulmonary embolism: do we need multiplanar reconstructions to evaluate the right ventricular dysfunction?
Journal of Computer Assisted Tomography
PURPOSE: To compare the indices of right ventricular dysfunction (RVD) obtained from axial transverse images with those derived from the reconstructed 4-chamber and short-axis views in patients with acute pulmonary embolism (PE). MATERIALS AND METHODS: Eighty-eight patients with acute PE were retrospectively enrolled. For each patient, axial transverse images and reconstructed 4-chamber and short-axis views were reviewed. Measurements of the ratios of right ventricle to left ventricle (RV/LV) diameters and RV/LV areas were then obtained from all series. Values derived from each method were compared and correlated to arterial obstruction index. RESULTS: In the studied cohort, RV/LV diameters and RV/LV areas obtained from axial transverse images and the reconstructed 4-chamber views were not statistically different. In contrast, a statistically significant difference was observed between the values of RV/LV areas derived from both axial transverse and 4-chamber views and those obtained from short-axis views (P < 0.0001). There was a weak to moderate correlation between both RV/LV diameters and RV/LV areas and the computed tomographic obstruction index. However, when the study cohort was divided into 3 subgroups with an arterial obstruction index of less than 15% (n = 26), 15% to 30% (n = 21), and greater than 30% (n = 41), those who had values greater than 30% revealed the highest correlation with the indices of RVD. CONCLUSIONS: In patients with acute PE, the indices of RVD derived from axial transverse images and the reconstructed 4-chamber views yield comparative values. Given the simplicity of the former analysis, it should be taken into consideration for risk stratification in acute PE.
Acute Disease, Aged, Angiography, Female, Heart Ventricles/radiography, Humans, Male, Middle Aged, Pulmonary Embolism/radiography, Retrospective Studies, Tomography, X-Ray Computed, Ventricular Dysfunction, Right/radiography
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