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KMID : 0383820100690030184
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Tuberculosis and Respiratory Diseases
2010 Volume.69 No. 3 p.184 ~ p.190
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Chest CT Parameters to Predict the Major Adverse Events in Acute Submassive Pulmonary Embolism
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Jung Sang-Ku
Kim Won-Young
Lee Cgoong-Wook
Seo Dong-Woo
Lee Yoon-Seon
Lee Jae-Ho
Oh Bum-Jin
Kim Won
Lim Kyoung-Soo
Hong Sang-Bum
Lim Chae-Man
Koh Youn-Suck
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Abstract
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Background : The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE).
Materials and Methods : Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE).
Results : There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis (36.4±8.0 vs. 41.7±7.4, p＜0.01; 45.7±9.4 vs. 41.5±7.6, p＜0.01), superior vena cava diameter (19.2±3.4 vs. 18.0±3.4, p=0.02), azygos vein diameter (10.0±2.2 vs. 9.2±2.3, p=0.02), septal displacement (19 vs. 18, p＜0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE (1.34±0.48 vs. 1.03±0.28, p＜0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62∼0.79).
Conclusion : RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.
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KEYWORD
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Pulmonary Embolism, Tomography, Prognosis
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