Academic Radiology
Volume 17, Issue 3 , Pages 309-315 , March 2010

Volumetric Analysis of Pulmonary CTA for the Assessment of Right Ventricular Dysfunction in Patients with Acute Pulmonary Embolism

  • Thomas Henzler, MD

      Affiliations

    • Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
    • Corresponding Author InformationAddress correspondence to: T.H.
    • ,
  • Radko Krissak, MD

      Affiliations

    • Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
    • ,
  • Miriam Reichert, MD

      Affiliations

    • Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
    • ,
  • Tim Sueselbeck, MD

      Affiliations

    • 1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
    • ,
  • Stefan O. Schoenberg, MD

      Affiliations

    • Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
    • ,
  • Christian Fink, MD

      Affiliations

    • Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany

Received 31 August 2009 ,Accepted 25 October 2009.

References 

  1. Goldhaber SZ. Pulmonary embolism. N Engl J Med. 1998;339:93–104
  2. Bell WR, Simon TL. Current status of pulmonary thromboembolic disease: pathophysiology, diagnosis, prevention, and treatment. Am Heart J. 1982;103:239–262
  3. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353:1386–1389
  4. Wood KE. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest. 2002;121:877–905
  5. Grifoni S, Olivotto I, Cecchini P, et al. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation. 2000;101:2817–2822
  6. Kreit JW. The impact of right ventricular dysfunction on the prognosis and therapy of normotensive patients with pulmonary embolism. Chest. 2004;125:1539–1545
  7. Leacche M, Unic D, Goldhaber SZ, et al. Modern surgical treatment of massive pulmonary embolism: results in 47 consecutive patients after rapid diagnosis and aggressive surgical approach. J Thorac Cardiovasc Surg. 2005;129:1018–1023
  8. Goldhaber SZ. Echocardiography in the management of pulmonary embolism. Ann Intern Med. 2002;136:691–700
  9. Kasper W, Konstantinides S, Geibel A, et al. Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart. 1997;77:346–349
  10. Vieillard-Baron A, Page B, Augarde R, et al. Acute cor pulmonale in massive pulmonary embolism: incidence, echocardiographic pattern, clinical implications and recovery rate. Intensive Care Med. 2001;27:1481–1486
  11. Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354:2317–2327
  12. Kelly AM, Patel S, Carlos RC, et al. Multidetector row CT pulmonary angiography and indirect venography for the diagnosis of venous thromboembolic disease in intensive care unit patients. Acad Radiol. 2006;13:486–495
  13. Weiss CR, Scatarige JC, Diette GB, et al. CT pulmonary angiography is the first-line imaging test for acute pulmonary embolism: a survey of US clinicians. Acad Radiol. 2006;13:434–446
  14. Dogan H, Kroft LJ, Huisman MV, et al. Right ventricular function in patients with acute pulmonary embolism: analysis with electrocardiography-synchronized multi-detector row CT. Radiology. 2007;242:78–84
  15. Contractor S, Maldjian PD, Sharma VK, et al. Role of helical CT in detecting right ventricular dysfunction secondary to acute pulmonary embolism. J Comput Assist Tomogr. 2002;26:587–591
  16. Groves AM, Win T, Charman SC, et al. Semi-quantitative assessment of tricuspid regurgitation on contrast-enhanced multidetector CT. Clin Radiol. 2004;59:715–719
  17. Mastora I, Remy-Jardin M, Masson P, et al. Severity of acute pulmonary embolism: evaluation of a new spiral CT angiographic score in correlation with echocardiographic data. Eur Radiol. 2003;13:29–35
  18. Qanadli SD, El Hajjam M, Vieillard-Baron A, et al. New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. AJR Am J Roentgenol. 2001;176:1415–1420
  19. Quiroz R, Kucher N, Schoepf UJ, et al. Right ventricular enlargement on chest computed tomography: prognostic role in acute pulmonary embolism. Circulation. 2004;109:2401–2404
  20. Reid JH. Semi-quantitative assessment of tricuspid regurgitation on contrast-enhanced multidetector CT. Clin Radiol. 2004;59:713–714
  21. Reid JH, Murchison JT. Acute right ventricular dilatation: a new helical CT sign of massive pulmonary embolism. Clin Radiol. 1998;53:694–698
  22. Bankier AA, Janata K, Fleischmann D, et al. Severity assessment of acute pulmonary embolism with spiral CT: evaluation of two modified angiographic scores and comparison with clinical data. J Thorac Imaging. 1997;12:150–158
  23. Mansencal N, Joseph T, Vieillard-Baron A, et al. Diagnosis of right ventricular dysfunction in acute pulmonary embolism using helical computed tomography. Am J Cardiol. 2005;95:1260–1263
  24. Schoepf UJ, Kucher N, Kipfmueller F, et al. Right ventricular enlargement on chest computed tomography: a predictor of early death in acute pulmonary embolism. Circulation. 2004;110:3276–3280
  25. Araoz PA, Gotway MB, Trowbridge RL, et al. Helical CT pulmonary angiography predictors of in-hospital morbidity and mortality in patients with acute pulmonary embolism. J Thorac Imaging. 2003;18:207–216
  26. Mansencal N, Joseph T, Vieillard-Baron A, et al. Comparison of different echocardiographic indexes secondary to right ventricular obstruction in acute pulmonary embolism. Am J Cardiol. 2003;92:116–119
  27. Schoepf UJ, Costello P. CT angiography for diagnosis of pulmonary embolism: state of the art. Radiology. 2004;230:329–337
  28. Schertler T, Frauenfelder T, Stolzmann P, et al. Triple rule-out CT in patients with suspicion of acute pulmonary embolism: findings and accuracy. Acad Radiol. 2009;16:708–717
  29. Ghaye B, Ghuysen A, Willems V, et al. Severe pulmonary embolism: pulmonary artery clot load scores and cardiovascular parameters as predictors of mortality. Radiology. 2006;239:884–891
  30. Lu MT, Ersoy H, Whitmore AG, et al. Reformatted four-chamber and short-axis views of the heart using thin section (</ = 2 mm) MDCT images. Acad Radiol. 2007;14:1108–1112
  31. Mayo JR, Aldrich J, Muller NL. Radiation exposure at chest CT: a statement of the Fleischner Society. Radiology. 2003;228:15–21
  32. Araoz PA, Gotway MB, Harrington JR, et al. Pulmonary embolism: prognostic CT findings. Radiology. 2007;242:889–897
  33. Ghuysen A, Ghaye B, Willems V, et al. Computed tomographic pulmonary angiography and prognostic significance in patients with acute pulmonary embolism. Thorax. 2005;60:956–961
  34. van der Meer RW, Pattynama PM, van Strijen MJ, et al. Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3-month follow-up in patients with acute pulmonary embolism. Radiology. 2005;235:798–803
  35. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–323
  36. Johnson TR, Nikolaou K, Becker A, et al. Dual-source CT for chest pain assessment. Eur Radiol. 2008;18:773–780
  37. Rahmani N, Jeudy J, White CS. Triple rule-out and dedicated coronary artery CTA: comparison of coronary artery image quality. Acad Radiol. 2009;16:604–609
  38. Aujesky D, Jimenez D, Mor MK, et al. Weekend versus weekday admission and mortality after acute pulmonary embolism. Circulation. 2009;119:962–968

PII: S1076-6332(09)00594-7

doi: 10.1016/j.acra.2009.10.022

Academic Radiology
Volume 17, Issue 3 , Pages 309-315 , March 2010

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