Computed tomographic angiography in acute pulmonary embolism: do we need multiplanar reconstructions to evaluate the...

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Right ventricular dysfunction (RVD) is a critical indicator in acute pulmonary embolism (PE).
• Accurate assessment of RVD is essential for prognosis and treatment decisions.

Purpose of the Study:

• To compare RVD indices from axial transverse images versus reconstructed 4-chamber and short-axis views in acute PE patients.
• To evaluate the utility of different imaging views for RVD assessment in PE.

Main Methods:

• Retrospective analysis of 88 acute PE patients.
• Comparison of right ventricle to left ventricle (RV/LV) diameter and area ratios from axial transverse, 4-chamber, and short-axis views.
• Correlation of RVD indices with the arterial obstruction index.

Main Results:

• No significant difference in RV/LV diameters and areas between axial transverse and 4-chamber views.
• Significant difference in RV/LV areas between axial transverse/4-chamber views and short-axis views (P < 0.0001).
• Higher correlation between RVD indices and obstruction index in patients with >30% obstruction.

Conclusions:

• Axial transverse and 4-chamber views provide comparable RVD indices in acute PE.
• Axial transverse imaging offers a simpler method for RVD assessment.
• Axial transverse imaging is recommended for risk stratification in acute PE.