The dynamic study of the massive pulmonary embolism on CT pulmonary angiography / 中华放射学杂志

ABSTRACT

Objective To dynamically evaluate the pulmonary artery obstruction index and the right ventricular function of the massive pulmonary embolism on CT pulmonary angiography (CTPA). Methods Twenty-three cases of massive pulmonary embolism were analyzed retrospectively. The pulmonary artery obstruction index (PAOI) and the right ventricular function parameters were collected and analyzed on CTPA before thrombolytic therapy, 24 hours and 14 days after therapy respectively. Student's ANOVA and LSD test was used to analyze the change of PAOI and quantification parameters of right ventricular function parameters. The right ventricular quantification parameters were analyzed by Chi-square test. Pearson correlation analysis was used to study the correlation of PAOI and right ventricular function. Results The PAOI decreased gradually after thrombolytic therapy. There was significant difference in Qanadli and Mastora scores between before (Qanadli score 50. 0,Mastora score 46. 5) and 24 hours (42. 5/12. 1) after therapy(t =2. 830,6. 493 ,P < 0. 01). The same significant difference also appeared between 24 hours and 14 days(Qanadli score 25.0,Mastora score 8.4) after therapy (t = 4. 640, 4. 299,P <0. 01). Twenty-four hoursafter therapy, the maximal minor diameter (RVd, 4. 58 cm) and maximal area (RVs 23. 10 cm2) of rightventricle decreased, the maximal minor diameter(LVd, 4. 41 cm) and maximal area (LV<,s>, 26. 37 cm2) ofleft ventricle increased, the RVd/LVd (1.07) and RVs/LVs (0. 94) decreased apparently. The aboveparameters were significantly different (t = 2. 081-4. 959, P < 0. 05) compared with which before therapy (5.07 cm, 25.42 cm2, 3.57 cm, 20. 17 cm2, 1.59, 1.38 respectively). The pulmonary artery symbolicpressure decreased from 58. 61 mm Hg before therapy to 40. 92 mm Hg 24 hours after therapy significantly(t = 2. 824, P < 0. 01). There was correlation to different degree between the PAOI and the right ventricularfunction parameters before therapy and 24 hours after therapy(r = 0. 034-0. 598, P < 0. 01). ConclusionCTPA can evaluate the pulmonary artery obstruction degree and right ventricular function after pulmonaryembolism dynamically.