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Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism – correlation with D-dimer level, right heart strain and clinical outcome

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Abstract

Objective

To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE).

Methods

53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected.

Results

D-dimer level was mildly (r = 0.43–0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD.

Conclusion

Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study.

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Acknowledgements

Ralf W. Bauer and J. Matthias Kerl: Research consultants and Speaker’s Bureau Siemens AG

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Ralf W. Bauer, Claudia Frellesen, Matthias Renker, Boris Schell, Thomas Lehnert, Volkmar Jacobi, Thomas J. Vogl & J. Matthias Kerl

  2. Heart&Vascular Center, Ashley River Tower, Medical University of South Carolina, MSC 226, 25 Courtenay Drive, Charleston, SC, 29401, USA

    Matthias Renker & U. Joseph Schoepf

  3. Department of Biostatistics and Mathematical Modelling, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Hanns Ackermann

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  1. Ralf W. Bauer
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Correspondence to Ralf W. Bauer.

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Bauer, R.W., Frellesen, C., Renker, M. et al. Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism – correlation with D-dimer level, right heart strain and clinical outcome. Eur Radiol 21, 1914–1921 (2011). https://doi.org/10.1007/s00330-011-2135-1

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  • DOI: https://doi.org/10.1007/s00330-011-2135-1

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