Chronic CT features in PE patients with co-existing DVT

Area of Science:

• Cardiology
• Radiology
• Pulmonary Medicine

Background:

• Clinical presentations of pulmonary embolism (PE) can vary based on the presence or absence of co-existing deep venous thrombosis (DVT).
• Understanding these differences is crucial for accurate diagnosis and patient management.

Purpose of the Study:

• To investigate and compare the distinct clinical features between patients with isolated PE and those with PE associated with DVT.

Main Methods:

• A prospective study involving 107 consecutive patients diagnosed with acute PE.
• Diagnosis confirmed via computed tomography pulmonary angiography (CTPA).
• Lower extremity compression ultrasound used to identify DVT; patients categorized as PE with or without DVT.

Main Results:

• 62.6% of patients had isolated PE, while 37.4% had PE with DVT.
• PE with DVT cases showed wider pulmonary arteries, higher d-dimer and pro BNP levels, and lower oxygen saturation.
• Central PE was significantly more prevalent in patients with DVT (87.5%) compared to those without (32.8%).
• Over one-third of central PEs occurred without lower extremity DVT.
• Patients with PE and DVT exhibited signs of chronic background changes, including mosaic perfusion and infarct appearance.

Conclusions:

• PE patients with co-existing DVT generally exhibit more severe clinical presentations.
• A significant proportion of PE with DVT cases may present with an acute picture superimposed on a chronic background.
• While central PE is common with DVT, a notable percentage of central PEs arise without concurrent lower extremity DVT.