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The relationship between computed tomographic obstruction index and pulmonary vein cross-sectional area in acute pulmonary embolism

  • CHEST RADIOLOGY
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Abstract

Purpose

To investigate whether the increased obstruction of the pulmonary arteries was associated with reduced pulmonary vein areas in acute pulmonary embolism (APE).

Method

We retrospectively analyzed a consecutive series of computed tomography pulmonary angiography studies of 107 patients with APE and 101 controls without APE between November 2010 and January 2019. The control and patient groups were compared with each other for differences between the mean cross-sectional areas of pulmonary veins. Further analysis was conducted by dividing the patient group into high-risk patients (≥ 20%) and low-risk patients (< 20%) according to the pulmonary arterial obstruction index. The mean cross-sectional area of the pulmonary veins in these two groups was compared.

Results

The mean cross-sectional areas of the 4 pulmonary veins at the ostium level (CSAPV) were significantly lower for the patient group (mean: 102.6 mm2) compared with the control group (111.8 mm2) (p < 0.001). CSAPV cutoff value for determining the diagnosis of APE that maximized the accuracy was 109.12 mm2 (AUC = 0.721; 95% CI 0.649–0.794); its sensitivity and specificity were 78.2% and 69.2%, respectively. CSAPV cutoff value for differentiating high-risk APE that maximized the accuracy was 102.6 mm2 (AUC = 0.634; 95% CI 0.525–0.743); its sensitivity and specificity were 61.9% and 53.8%, respectively.

Conclusions

There is a negative correlation between the CSAPV and thrombotic material burden in the pulmonary arteries of patients with APE. Hence, the CSAPV can be used as a diagnostic tool in the evaluation of the presence and severity of pulmonary embolism.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Trakya University, Edirne, Turkey

    Fethi Emre Ustabaşıoğlu, Serdar Solak, Osman Kula, Burak Gunay & Nermin Tunçbilek

  2. Department of Chest Diseases, Faculty of Medicine, Trakya University, Edirne, Turkey

    Bilkay Serez

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  1. Fethi Emre Ustabaşıoğlu
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  2. Serdar Solak
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  3. Osman Kula
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  4. Burak Gunay
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  6. Nermin Tunçbilek
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Correspondence to Fethi Emre Ustabaşıoğlu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Our studies were approved by the ethics committee and we received informed consent form from the patients.

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Ustabaşıoğlu, F.E., Solak, S., Kula, O. et al. The relationship between computed tomographic obstruction index and pulmonary vein cross-sectional area in acute pulmonary embolism. Radiol med 125, 265–271 (2020). https://doi.org/10.1007/s11547-019-01119-4

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  • DOI: https://doi.org/10.1007/s11547-019-01119-4

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