Varol Kenan, Gumus Cesur, Yucel Hasan, Sezer Ferhat, Seker Emrah, Inci Mehmet Fatih, Yucel Selma, Kaya Hakki, Berk Serdar, Yilmaz Mehmet Birhan
Divison of Radiology, Amasya University SS Education and Research Hospital, Amasya, Turkey.
Jpn J Radiol. 2015 Jun;33(6):311-6. doi: 10.1007/s11604-015-0419-0. Epub 2015 Apr 18.
The aim of this study was to determine the pulmonary artery computed tomography obstruction index ratio (PACTOIR) in patients who have been diagnosed with acute pulmonary embolism (APE) with multi-slice computed tomography (MSCT) and to research the predetermination efficiency of right ventricular dysfunction (RVD) compared with echocardiography (ECHO).
One hundred patients (50 males, 50 females), who had ECHO findings and were diagnosed with APE, were subsequently examined in this study. Patients who had RVD on ECHO, tricuspid regurgitation, and pulmonary hypertension parameters that were completely positive were accepted to have RVD.
RVD was identified in 52 patients (52 %) on echocardiography. The PACTOIR value for patients with RVD were evaluated to be significantly higher than those without RVD (41 ± 17 vs 20 ± 12 %, p < 0.001). In the ROC analysis, the PACTOIR cut-off value was 37.5 %, the sensitivity value was 67.3 %, and specificity value was 93.7 % (AUC 0.839, 95 % CI 0.752-0.905). We determined that the patients with RVD and PACTOIR values over 37.5 % can be recognized with a 92.1 % positive predictive value.
Our conclusions indicated that the PACTOIR rate in RVD diagnosis in patients with APE can recognize the patients with and without RVD.
本研究旨在通过多层螺旋计算机断层扫描（MSCT）测定已诊断为急性肺栓塞（APE）患者的肺动脉计算机断层扫描阻塞指数比（PACTOIR），并与超声心动图（ECHO）比较研究右心室功能障碍（RVD）的预测效率。
本研究纳入100例有ECHO检查结果且诊断为APE的患者（50例男性，50例女性）。ECHO检查显示RVD、三尖瓣反流及肺动脉高压参数完全阳性的患者被判定为存在RVD。
超声心动图检查发现52例患者（52%）存在RVD。RVD患者的PACTOIR值显著高于无RVD患者（41±17%对20±12%，p<0.001）。在ROC分析中，PACTOIR临界值为37.5%，敏感度为67.3%，特异度为93.7%（AUC 0.839，95%CI 0.752-0.905）。我们确定RVD且PACTOIR值超过37.5%的患者，其阳性预测值为92.1%。
我们的结论表明，APE患者RVD诊断中的PACTOIR率可识别有无RVD的患者。
