The Evaluation Of Severity Of The Radiological Massive Pulmonary Embolism By CT Pulmonary Angiography

Objective:To analysis the correlation of Pulmonary artery obstruction index(PAOI) and the cardiovascular parameters in the radiographical massive pulmonary embolism(MPE) and to explore the CT pulmonary angiography(CTPA) in radiographical massive pulmonary embolism severity stratification. Methods:62 patients with the radiographical massive pulmonary embolism proved by CTPA, the correlation between Pulmonary artery obstruction index and cardiovascular parameters of 62 patients was analyzed. According to the clinical severity, 62 patients were classified into two groups, high-risk group(17 cases) and non-high-risk group(45 cases). Pulmonary artery obstruction index, ratio of main pulmonary artery diameter(MPAd) to the ascending main atery diameter(AAd),namely rPA, ratio of right ventricular diameter(RVd) to left ventricular diameter(LVd),namely RVd/LVd in both groups were analyzed comparatively. Results: Pulmonary artery obstruction index and the cardiovascular parameters have different degree of correlation and there are remarkable correlation between PAOI and RVd/LVd(r = 0.657, P=0.000). PAOI(45%-82.5%, median 45%), MPA(3.43±0.40), rPA(1.18-1.05, median 1.46) and RVd/LVd(0.87-2.12, median 1.49,) and RVd(5.20±0.98) in high-risk group, were higher than those corresponding factors(17.5%-67.5%,median17.5%,2.84±0.38, 0.65-1.17, median 0.91, 0.70-1.83, median 0.99, 4.27±0.47)in non-high-risk group,but LVd(3.54±0.47) in high-risk group is lower than LVd(4.20±0.54) in non-high-risk group. Both groups were of significantly differences(Z = 5.64, T = 5.33, Z = 5.44, Z = 4.54, T = 3.74, T = 4.43). Conclusion:CTPA can not only effectively evaluate the degree of embolization of pulmonary embolism but also can assess the severity of the patients with the radiological massive pulmonary embolism in the first time.