Abstract

OBJECTIVES: In this study, we aimed to determine thrombus localizations and the relationship between this localizations and right ventricular dysfunction (RVD) in pulmonary embolism (PE) patients diagnosed with computed tomography pulmonary angiography (CTPA).

MATERIAL AND METHODS: CTPA and echocardiography (ECHO) findings of 59 patients (35 male, 24 female) with PE that diagnosed by CTPA were analyzed retrospectively. Localizations of thrombus that observed in the CTPA were determined. Patients were divided into 2 groups according to ECHO findings; without RVD (group 1) and the with RVD (group 2).

RESULTS: The most frequent thrombus localizations respectively in the right main pulmonary artery (33.8%) and right lower lobar artery (30.5%) were observed. Thrombus in the right system was found to be statistically significantly higher (right system 63.8%, left system 36.2%, p<0.01). 16 of the 59 patients were determined RVD in ECHO. Patients with thrombus in the right main pulmonary artery statistically significant took part in group 2 (p<0.001). Pulmonary trunk diameter measured by CT at group 1 (28 mm±3.61) was significantly lower according to the group 2 (37 mm±5.88) (p<0.01). Statistically significant positive correlation was found between systolic pulmonary artery pressure and diameter of right ventricular and pulmonary trunk (p<0.001). Sensitivity, specificity and positive predictive value of CTPA respectively were 87.5% (14/16), 95.3% (41/43), 87.5% (14/16) in detection of RVD.

CONCLUSION: Probability of RVD is higher in patients with thrombus in right main pulmonary artery. There is a strong relationship between the diameter of the pulmonary trunk and the right ventricle measured by CT and RVD observed with ECHO. CTPA is a reliable imaging method in detecting of RVD in patients with PE.