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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Takx, RAP; Henzler, T; Schoepf, UJ; Germann, T; Schoenberg, SO; Shirinova, A; Bauer, RW; Frellesen, C; Zhang, LJ; Nance, JW; Fink, C; Apfaltrer, P.
Predictive value of perfusion defects on dual energy CTA in the absence of thromboembolic clots.
J Cardiovasc Comput Tomogr. 2017; 11(3): 183-187.
Doi: 10.1016/j.jcct.2017.04.005
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Apfaltrer Paul
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- Abstract:
- To determine the predictive value of volumetrically measured lung perfusion defects (PDvol) and right ventricular dysfunction on dual-energy computed tomography angiography (DE-CTA) for predicting all cause mortality in patients suspected of pulmonary embolism (PE) but without evident thromboembolic clot on CTA. 448 patients underwent DE-CTA on a 64-channel DSCT system between January 2007 and December 2012 for suspected PE, of which 115 were without detectable thromboembolic clot on CTA. Diagnostic performance for identifying patients at risk of dying was evaluated using ROC analysis. All-cause mortality was assessed via the hospital electronic medical records and/or consultation of the patient or the patient's primary care physician via phone call interviews. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve (AUC) were determined for PDvol (volume of perfusion defects/total lung volume), transverse right ventricular to left ventricular diameter ratios (RV/LV) and for the combination of both tests. Mortality was 38% within the investigated time period of 6 months. Patients who died had significantly higher PDvol (PDvol 28 ± 13% vs. 19 ± 12%, p < 0.001) and a non-significant difference in transverse RV/LV ratio (1.14 ± 0.37 vs. 1.06 ± 0.22, p = 0.159). The AUC was 0.71 for PDvol, 0.53 for RV/LV ratio, and 0.67 for the combination of PDvol and RV/LV ratio. PDvol remained a significant predictor after correcting for age. In the absence of thromboembolic clots, PDvol at DE-CTA appears to be predictive for all cause mortality. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Area Under Curve -
- Computed Tomography Angiography -
- Female -
- Humans -
- Male -
- Middle Aged -
- Multidetector Computed Tomography -
- Perfusion Imaging - methods
- Predictive Value of Tests -
- Prognosis -
- Pulmonary Circulation -
- Pulmonary Embolism - diagnostic imaging
- Pulmonary Embolism - mortality
- Pulmonary Embolism - physiopathology
- ROC Curve -
- Reproducibility of Results -
- Retrospective Studies -
- Risk Factors -
- Time Factors -
- Ventricular Dysfunction, Right - diagnostic imaging
- Ventricular Dysfunction, Right - mortality
- Ventricular Dysfunction, Right - physiopathology
- Ventricular Function, Left -
- Ventricular Function, Right -
- Find related publications in this database (Keywords)
- Dual energy CT
- Risk assessment
- Pulmonary embolism
- Multidetector computed tomography
- Ventricular dysfunction
- Right
- ROC curve