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Evolutionary changes in thrombus features on computed tomography: An effective approach for identifying subacute
Hsien-Yuan Chang1, Po-Wei Chen1, Wei-Ting Chang2
1Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Journal of Vascular Surgery. Venous and Lymphatic Disorders
|August 12, 2022
Summary
Computed tomography (CT) thrombus features can now identify subacute pulmonary embolism (PE). Subacute PE carries similar clinical deterioration and mortality risks to acute PE, aiding in diagnosis and patient management.
Area of Science:
- Radiology
- Pulmonary Medicine
- Cardiovascular Imaging
Background:
- Distinguishing acute from chronic pulmonary embolism (PE) is crucial for treatment.
- Thrombus characteristics on computed tomography (CT) aid in this differentiation.
- However, CT features of subacute PE remain poorly understood.
Purpose of the Study:
- To identify and verify specific thrombus features on CT indicative of subacute PE.
- To compare clinical deterioration and 1-month mortality rates between acute and subacute PE.
- To establish the diagnostic accuracy of identified subacute PE features.
Main Methods:
- Retrospective analysis of 358 PE patients from 2008-2019, divided into study and verification groups.
- Temporal analysis of thrombus features in the study group to identify changes over time.
- Determination and verification of subacute PE features, followed by comparison of clinical outcomes.
Main Results:
- Key evolving thrombus features included arterial wall angle (eccentric) and recanalization/heterogeneity (centric).
- Subacute PE was characterized by an obtuse angle with the arterial wall, recanalization, and heterogeneity, achieving 94% accuracy.
- No significant differences in clinical deterioration or 1-month mortality were observed between acute and subacute PE groups.
Conclusions:
- CT thrombus features can be used to effectively identify subacute PE events.
- Subacute PE does not confer a different risk of clinical deterioration or 1-month mortality compared to acute PE.
- These findings enhance the diagnostic capabilities for PE staging and risk stratification.
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