New CT Index to Quantify Arterial Obstruction in Pulmonary Embolism
Top Cited Papers
- 1 June 2001
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 176 (6), 1415-1420
- https://doi.org/10.2214/ajr.176.6.1761415
Abstract
OBJECTIVE. This study was designed to define and evaluate a specific index to quantify arterial obstruction with helical CT in acute pulmonary embolism. MATERIALS AND METHODS. Fifty-four patients (mean age, 56 years) with proven pulmonary emboli among 158 consecutive patients, who had undergone both CT and pulmonary angiography for clinically suspected pulmonary embolism, were eligible for the study. The CT obstruction index was defined as Σ(n · d) (n, value of the proximal clot site, equal to the number of segmental branches arising distally; d, degree of obstruction scored as partial obstruction [value of 1] or total obstruction [value of 2]). We compared the CT obstruction index with pulmonary arterial obstruction on angiography (assessed by the Miller index), using linear regression, and correlated it with findings on echocardiography. Interobserver variability was determined for both CT and pulmonary angiography indexes. RESULTS. The CT obstruction index (29% ± 17%) and the Miller index (43% ± 25%) were well correlated (r = 0.867, p < 0.0001) with an excellent concordance between investigators for both the CT index (r = 0.944, p < 0.0001) and the Miller index (r = 0.904, p < 0.0001). A CT obstruction index greater than 40% identified more than 90% of patients with right ventricular dilatation. CONCLUSION. The degree of arterial obstruction in pulmonary embolism may be quantified by a specific CT index that appears reproducible and highly correlated to the previously described index with pulmonary angiography. Further evaluations are needed to investigate the usefulness of the CT obstruction index for stratification of patient risk and determining therapeutic options.Keywords
This publication has 24 references indexed in Scilit:
- Pulmonary Embolism Detection: Prospective Evaluation of Dual-Section Helical CT versus Selective Pulmonary Arteriography in 157 PatientsRadiology, 2000
- Acute pulmonary embolism: assessment of helical CT for diagnosis.Radiology, 1998
- Pulmonary embolism: diagnosis with spiral CT and ventilation-perfusion scanning--correlation with pulmonary angiographic results or clinical outcome.Radiology, 1998
- Acute pulmonary embolism: role of helical CT in 164 patients with intermediate probability at ventilation-perfusion scintigraphy and normal results at duplex US of the legs.Radiology, 1997
- Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy.Radiology, 1997
- Pulmonary embolism: validation of spiral CT angiography in 149 patients.Radiology, 1996
- Diagnosis of pulmonary embolism with spiral CT: comparison with pulmonary angiography and scintigraphy.Radiology, 1996
- Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography.American Journal of Roentgenology, 1995
- The Clinical Course of Pulmonary EmbolismNew England Journal of Medicine, 1992
- Nonuniform Pulmonary Arterial PerfusionRadiology, 1971