Estimation of prognostic value of computed tomography (CT) procedure in pulmonary embolism
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II Department of Radiology, Medical University, Lublin, Poland
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Witold Krupski   

MD, PhD, II Department of Radiology, Medical University, Staszica 16, 20-081 Lublin, Poland.
J Pre Clin Clin Res. 2009;3(1):49-53
Due to the fact that the signs and symptoms of pulmonary embolism (PE) are nonspecific, its diagnosis continues to pose a challenge for both clinicians and radiologists. Helical computed tomography (CT) of the pulmonary arteries is deemed accurate test for the detection of PE and is gaining increasing acceptance in daily clinical practice as a first-line test for diagnosing acute PE. The purpose of this work is to estimate the prognostic value of CT procedure in patients with diagnosed pulmonary embolism. Retrospective estimation of the embolic pulmonary index (PE index - Quanadli), diameter of pulmonary trunk (dAP), diameter of the aorta (dA), ratio dAP/dA, dimension of the right heart ventricle (dRV), left heart ventricle (dLV), and the ratio dRV/dLV were performed using sequential angio-CT procedures in patients with diagnosed pulmonary embolism. The research embraced a group of 43 patients with CT diagnosed pulmonary embolism (24 women, 19 men), aged from 26 - 91 years (mean age 66.9: women 72.2, men 60.1). In the tested material, the value of the Quanadli index ranged from 15 - 77, the diameter of the arteria pulmonalis trunk from 1.8 - 4 cm, the diameter of the aorta from 2.38 - 4.99 cm, the ratio of the pulmonary trunk diameter and the diameter of the aorta from 0.54 - 1.11, the dimension of the right heart ventricle from 2.24 - 5.93 cm, the dimension of the left heart ventricle from 2.04 - 5.58 cm and the ratio of both heart ventricles measurements ranged between 0.6 - 2.55. Three persons from the analyzed group of patients died during the hospitalization period (1 woman and 2 men aged 47, 64 and 61). The Quanadli index for these persons amounted to: 57.5, 42.5 and 50, accordingly. In conclusion, the Quanadli index is an objective and repeatable indicator which is easy to utilize in a standard way when dealing with patients suffering from pulmonary embolism diagnosed using CT examination. High values of the Quanadli index – above 40% – should be a signal to consider fibrynolytic treatment. The Quanadli index is not useful in assessing the risk of death of patients suffering from pulmonary embolism.
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