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Resumen de Medición de la carga embólica y relación ventrículo derecho/ventrículo izquierdo en tomografía computada como indicadores de riesgo en pacientes con tromboembolismo pulmonar

Juan Carlos Díaz, David Ladrón de Guevara H., Gonzalo Pereira R., Rodrigo Herrmann, Claudio Silva, Erika Astorga, Marcelo Llancaqueo

  • Background: In pulmonary embolism, the computed tomography (CT) images can be used as a prognostic index measuring the embolic load, according to the location and size of thrombus and the right/left ventricular diameter ratio. Aim To assess the predictive value of embolic load and right/left ventricular diameter ratio for early and ¡ate mortality in acute pulmonary embolism (PTE). Material and methods: The pulmonary CT of 418 patients with suspected PTE were reviewed. Embolic load was assessed by three independent evaluators and the right/left ventricular diameter ratio was measured in those exams that were positive for PTE. A logistic regression analysis was done between these parameters and mortality. ReproducibUity was calculated using Bland andAltman analysis. Results: There was a high concordance between raters to calculate embolic load (r =0,95, p <0,001). Only the right/left ventricular diameter ratio and the presence were predictive of global mortality. The predictive value for embolic load was below the significance level No parameter was predictive of early mortality. Conclusions: The concordance between raters for the assessment of embolic load was high in this study. However no imaging parameter had a predictive value for early mortality. The right/left ventricular diameter ratio had a predictive value for global mortality at three months


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