Evaluation Of Short-term Prognosis Of Patients With Acute Pulmonary Embolism By 320-slice CT Pulmonary Subtraction Technique

Objective: To investigate the clinical value of the lung perfusion defect score derived from 320-slice CT lung subtraction technique to predict the short-term prognosis of patients with acute pulmonary embolism(APE).Methods: Clinical data were collected from 71 patients with APE who underwent CT lung subtraction scanning in our hospital.The patients’ perfusion defect score,pulmonary artery embolism index(PAOI)and right ventricle/left ventricle(RV/LV)were recorded,and their correlation was calculated by Spearman correlation method.Patients were divided into good prognosis and poor prognosis groups according to clinical outcome.Differences in CT parameters and general data(age,sex)between the groups were compared using the Mann-Whitney U test.Receiver operating characteristic curve(ROC)was used to evaluate the predictive efficacy of CT parameters for clinical adverse outcomes,and the area under the curve(AUC)was compared by Delong test to screen out the best predictive indicators.Results: Significant positive correlation was found between perfusion defect score and RV/LV,PAOI and RV/LV,and between perfusion defect score and PAOI.rs was 0.891,0.735 and 0.780 respectively(P<0.01).There was no significant difference in age and sex between the good prognosis group and the poor prognosis group(P>0.05).There were significant differences in perfusion defect score,PAOI and RV/LV between the good prognosis group and the poor prognosis group(P<0.01),and their AUC were 0.922,0.840 and 0.921 respectively.The results of Delong test showed that there was a significant difference between the AUC of perfusion defect score and the AUC of PAOI(Z=2.290,P=0.022).Conclusion: 1 A significant positive correlation was found between perfusion defect score and RV/LV,PAOI and RV/LV as well as perfusion defect score and PAOI.2 Perfusion defect score,RV/LV and PAOI all had predictive value for short term poor prognosis of APE patients,but the perfusion defect score derived from lung subtraction technique with CT had higher predictive value.