Application of a New Pulmonary Artery Obstruction Score in the Prognostic Evaluation of Acute Pulmonary Embolism: Comparison with Clinical and Haemodynamic Parameters

Overview

Journal Radiol Med

Specialty Radiology

Date 2011 Feb 12

PMID 21311989

Citations 7

Authors

D Attina

M Valentino

N Galie

C Modolon

F Buia

F De Luca

M L Bacchi-Reggiani

M Zompatori

Affiliations

Soon will be listed here.

Abstract

Purpose: Evaluation of computed tomography (CT) pulmonary angiography parameters revealing pulmonary embolism (PE) severity with particular attention to pulmonary obstruction indexes. Comparison with clinical and hemodynamic data and determination of predictive role in the development of chronic pulmonary heart disease.

Materials And Methods: This retrospective study analyzes 45 not consecutive patients from November 2007 to December 2008 with CT angiography diagnosis of acute PE. Included in the study are patients at the first documented episode of acute PE, with 6 month follow-up. Patients with severe pre-existent cardiopulmonary pathology or neoplastic diseases were excluded from the study. CT angiography evaluated right ventricular (RV)/left ventricular (LV) ratio, obstruction index according to Qanadli and Total Clot Burden (Ghanima score). PE indexes were compared with Troponin I measurement and echocardiography result; at last hospitalization and intensive care time were reported.

Results: A significant association was found between Ghanima and Qanadli score: the two indexes are equivalent in quantification of pulmonary arterial obstruction (p<0.001). Among others CT parameters, the new Ghanima score evidenced the best accuracy to detect patients evolving to chronic pulmonary heart disease (76%). This value is higher than that of echocardiography (71%). Troponins showed highest accuracy (82%).

Conclusions: Ghanima score can be used in emergency CT angiography diagnosis as prognostic marker for a quickly risk stratification of pulmonary heart disease or death in patients with acute PE. This approach allows to obtain, with just one test, both the diagnosis and a rather accurate acute PE risk stratification.

Citing Articles

Current Role of CT Pulmonary Angiography in Pulmonary Embolism: A State-of-the-Art Review.

Diaz-Lorenzo I, Alonso-Burgos A, Friera Reyes A, Pacios Blanco R, de Benavides Bernaldo de Quiros M, Gallardo Madueno G J Imaging. 2024; 10(12).

PMID: 39728220 PMC: 11678867. DOI: 10.3390/jimaging10120323.

Comparison of Qanadli score with conventional risk stratifiers in non-massive pulmonary emboli.

Hajsadeghi S, Shamsedini A, Bahadoran P, Amouei E, Mirshafiee S J Int Med Res. 2024; 52(9):3000605241276481.

PMID: 39301817 PMC: 11418528. DOI: 10.1177/03000605241276481.

CT Pulmonary Angiography for Risk Stratification of Patients with Nonmassive Acute Pulmonary Embolism.

Rotzinger D, Knebel J, Jouannic A, Adler G, Qanadli S Radiol Cardiothorac Imaging. 2021; 2(4):e190188.

PMID: 33778598 PMC: 7978016. DOI: 10.1148/ryct.2020190188.

Pulmonary Vessel Obstruction Does Not Correlate with Severity of Pulmonary Embolism.

Lerche M, Bailis N, Akritidou M, Meyer H, Surov A J Clin Med. 2019; 8(5).

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Clinical and echocardiographic findings of patients with suspected acute pulmonary thromboembolism who underwent computed tomography pulmonary angiography.

Adibi A, Nouri S, Moradi M, Shahabi J J Res Med Sci. 2017; 21:118.

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