Predictive value of D-dimer and multiple dual-energy CT indicators for assessing the risk of pulmonary embolism

Logistic regression was performed to estimate the association between D-dimer level 、the main pulmonary artery-to-ascending aorta diameter ratio, the right-to-left ventricular (RV/LV) diameter ratio, the pulmonary embolism (PE) index, and the perfusion defect index and PE risk stratification. And to evaluate the predictive value of these parameters for identifying severe PE.

A retrospective analysis was conducted on the clinical data of 52 patients diagnosed with PE by dual-source CT pulmonary angiography in the author's hospital. Based on clinical manifestations, patients were classified into a severe group and a non-severe group. Statistical analyses were performed using professional software to assess D-dimer, the main pulmonary artery-to-ascending aorta diameter ratio, RV/LV diameter ratio, PE index, perfusion defect index, and PE risk stratification. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of these parameters for severe PE.

Levels of RV/LV diameter ratio, PE index, and perfusion defect index were significantly higher in the severe group than in the non-severe group (P < 0.05). ROC curve analysis showed that pulmonary embolism index (AUC = 0.850, 95%CI: 0.724-0.934) and perfusion defect index (AUC = 0.840, 95%CI: 0.712-0.927) had good differentiation efficiency for the severe group.

D-dimer levels were not correlated with the risk stratification of PE. The RV/LV diameter ratio can serve as reference indicators for identifying severe PE patients. Both the perfusion defect index and the PE index demonstrated good predictive value for severe cases. These findings offer valuable insights for optimizing the clinical management and treatment strategies for PE patients.