The value of CT pulmonary angiography to the diagnosis of right ventricular dysfunction due to acute pulmonary embolism: compared with ultrasonographic cardiography
Jianguo Wang
Li Zhu
Min Liu
Xiaojuan Guo
Chen Wang
Youmin Guo
Yuanhua Yang
Zhenguo Zhai
Hongxia Ma
Yulin Guo
摘要：Objective:To analyze the value of CT pulmonary angiography(CTPA) in assessing right ventricular dysfunction(RVD) after acutepulmonary embolism. Methods:Thirty-six patients with CTPA-confirmed PE who underwent ultrasonic cardiography(UCG) withinthe ensuing 24 hours were retrospectively reviewed. According to the severity of the disease, the patients were divided into the massivePE group(24 cases) and non-massive PE group(12 cases) respectively. CT scans were analyzed for findings suggestive of RVD. Scanswere considered positive for RVD if the right ventricle was dilated(RVd/LVd > 1) or if the interventricular septum was straightened ordeviated towards the left ventricle. Results were then compared with the results of UCG to estimate the value of CTPA in detecting RVDassociated with PE. Results:In all cases, compared with UCG, the diagnostic sensitivity, specificity, positive likelihood ratio, negativelikelihood ratio, positive predictive value, and negative predictive value of CTPA was 84.61%, 78.26%, 3.892, 0.197, 68.75% and 90%respectively. Kappa value was 0.60, which suggested moderate agreement between CTPA and UCG in the whole level. In the massivePE group, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negativepredictive value of CTPA was 84.61%, 72.73%, 3.103, 0.212, 78.57% and 80% respectively. Kappa value was 0.58, which suggestedmoderate agreement between CTPA and UCG in the massive PE group. In the non-massive PE group, the diagnostic specificity ofCTPA was 83.33%. By statistics, the value of RVd/LVd had significant difference between the massive PE and the non-massive PEgroup. Conclusion:CTPA can reliably detect RVD through the evaluation of cardiac morphology. However, this result requiresconfirmation using a larger prospective cohort study.
机标关键词：pulmonary embolismventricular dysfunctiondiagnosis oflikelihood ratioprospective cohort studyultrasonic cardiographypulmonary angiographyleft ventricle
分类号：R5(内科学)
资助基金：国家科学项目(2006BAI01A06)Shen-zhen City Luohu DistrictFoundation(2007029)
论文发表日期：2008-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：4( 234-237 )
英文信息