Quantitative CT Evaluation of Small Pulmonary Vessels in Patients with Acute Pulmonary Embolism

Publication date: Available online 10 January 2018
Source:Academic Radiology
Author(s): Shin Matsuoka, Akiyuki Kotoku, Tsuneo Yamashiro, Shoichiro Matsushita, Atsuko Fujikawa, Kunihiro Yagihashi, Yasuo Nakajima
Rationale and ObjectivesThe objective of this study was to investigate the correlation between the computed tomography (CT) cross-sectional area (CSA) of small pulmonary vessels and the CT obstruction index in patients with acute pulmonary embolism (PE) and the correlation between the changes in these measurements after anticoagulant therapy.Materials and MethodsFifty-two patients with acute PE were selected for this study. We measured the CSA less than 5 mm² on coronal reconstructed images to obtain the percentage of the CSA (%CSA < 5). CT angiographic index was obtained based on the Qanadli method for the evaluation of the degree of pulmonary arterial obstruction. Spearman rank correlation analysis was used to evaluate the relationship between the initial and the follow-up values and changes in the %CSA < 5 and the CT obstruction index.ResultsThere was no significant correlation between the %CSA < 5 and CT obstruction index on both initial (ρ = −0.03, P = 0.84) and follow-up (ρ = −0.03, P = 0.82) assessments. In contrast, there was a significant negative correlation between the changes in %CSA < 5 and the CT obstruction index (ρ = −0.59, P < 0.0001).ConclusionsAlthough the absolute %CSA < 5 and CT obstruction index were not significantly correlated, the changes in the values of the two parameters had a significant correlation. Changes in %CSA < 5, which can be obtained easily, can be used as biomarker of therapeutic response in patients with acute PE.



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