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EDUCATION EXHIBIT |
1 From the Departments of Medical Imaging (B.G., P.J.B., R.F.D.) and Medicine (A.G., V.D.), University Hospital of Liege, Sart Tilman B35, B-4000 Liege, Belgium. Recipient of a Certificate of Merit award for an education exhibit at the 2004 RSNA Annual Meeting. Received March 24, 2005; revision requested April 28 and received July 11; accepted August 18. All authors have no financial relationships to disclose. Address correspondence to B.G. (e-mail: bghaye{at}chu.ulg.ac.be).
Computed tomographic (CT) pulmonary angiography has been established as a first-line diagnostic technique in patients suspected of having pulmonary embolism. Risk stratification is important in patients with pulmonary embolism because optimal management, monitoring, and therapeutic strategies depend on the prognosis. Acute right-sided heart failure is known to be responsible for circulatory collapse and death in patients with severe pulmonary embolism. Acute right-sided heart failure can be assessed at CT pulmonary angiography by measuring the dimensions of right-sided heart cavities or upstream venous structures, such as the superior vena cava or azygos vein. The magnitude of pulmonary embolism can be calculated at CT pulmonary angiography by applying angiographic scores adapted for CT (Miller and Walsh scores) or dedicated CT scores (Qanadli and Mastora scores). The advent of CT pulmonary angiography performed with electrocardiographic gating permits new advances in assessment of acute right-sided heart failure, such as measurement of the ventricular ejection fraction. Although such findings may be useful for assessment of treatment effectiveness, their effect on prognosis in patients with severe pulmonary embolism is debated in the literature.
SUPPLEMENTAL MATERIAL
Movie clips to supplement this article are available online at radiographics.rsnajnls.org/cgi/content/full/26/1/23/DC1.
© RSNA, 2006
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