Computed tomography evaluation of right heart dysfunction in patients with acute pulmonary embolism

Journal of Computer Assisted Tomography
Hongying HeLinda B Haramati

Abstract

To evaluate the role of qualitative assessment of right heart dysfunction on multidetector computed tomography (CT) in patients with acute pulmonary embolism. Seventy-four consecutive adults with pulmonary embolism diagnosed on multidetector nongated CT were identified between July 2002 and March 2004. There were 47 women and 27 men, with a mean age of 62 years. Each CT scan was jointly reviewed by 2 of 3 reviewers in consensus. The CT scans were qualitatively assessed for dilatation of the right ventricle and the position of the interventricular septum. Scans were considered positive for right heart dysfunction if, on visual integration of multiple axial images, the right ventricle was dilated or the interventricular septum was straightened or bowed into the left ventricle. The extent of pulmonary vascular obstruction was graded using the CT clot burden scoring system. Reports of echocardiograms (n = 30) were reviewed when available. The sensitivity and specificity of CT and echocardiography in demonstrating right heart dysfunction were calculated and compared using pulmonary vascular obstruction of > or =30% as the reference standard. Sixty-six percent (49 of 74 patients) with pulmonary embolism had right heart dysfunction on...Continue Reading

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