Diagnostics of Pulmonary Embolism and Right Ventricular Dysfunction

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 4172

Special Issue Editor


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Guest Editor
Department of Radiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
Interests: pulmonary embolism; right ventricular dysfunction; hyperpolarized 13 C-pyruvate MRS; interventional neuroradiology

Special Issue Information

Dear Colleagues,

Pulmonary embolism (PE) is one of the leading causes of cardiovascular-related mortality in the western world. Early diagnosis and treatment of PE are essential for optimizing clinical outcomes. The diagnosis of PE is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation–perfusion (V/Q) scintigraphy or pulmonary multidetector CT angiography (CTA). Much has happened since the publication of the PIOPEP studies. The last few years have seen an increase in the use of dual energy CT with iodine mapping with an increase in diagnosis of segmental and subsegmental pulmonary emboli compared to pulmonary CTA. Which of the methods to use in PE diagnostic has not been determined, and limited data comparing these modalities are available. Continuously acute PE may lead to right ventricular dilatation and failure and represent a group with high mortality. Assessment of RV function is, however, cumbersome due to complex geometry. Right ventricle dysfunction (RVD) is usually established by echocardiography, which is observer-dependent, has low reproducibility, and requires expertise. Therefore, a simple and reproducible method to assess RVD in patients with PE would be desirable.

This Special Issue invites submission of both original and review papers, technical as well as clinical papers within all aspects of pulmonary embolism imaging and right ventricle dysfunction in the context of PE.

Dr. Henrik Gutte
Guest Editor

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Keywords

  • Pulmonary embolism
  • V/Q-SPECT imaging
  • Computed tomography pulmonary angiography
  • Dual energy CT
  • MRI
  • Right ventricular dysfunction

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Published Papers (1 paper)

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Research

10 pages, 1732 KiB  
Article
Acute Pulmonary Embolism Severity Assessment Evaluated with Dual Energy CT Perfusion Compared to Conventional CT Angiographic Measurements
by Samir Jawad, Peter Sommer Ulriksen, Anna Kalhauge and Kristoffer Lindskov Hansen
Diagnostics 2021, 11(3), 495; https://doi.org/10.3390/diagnostics11030495 - 11 Mar 2021
Cited by 4 | Viewed by 3834
Abstract
The purpose of the study was to investigate whether Dual Energy CT (DECT) can be used as a diagnostic tool to assess the severity of acute pulmonary embolism (PE) by correlating parenchymal perfusion defect volume, obstruction score and right ventricular-to-left ventricular (RV/LV) diameter [...] Read more.
The purpose of the study was to investigate whether Dual Energy CT (DECT) can be used as a diagnostic tool to assess the severity of acute pulmonary embolism (PE) by correlating parenchymal perfusion defect volume, obstruction score and right ventricular-to-left ventricular (RV/LV) diameter ratio using CT angiography (CTA) and DECT perfusion imaging. A total of 43 patients who underwent CTA and DECT perfusion imaging with clinical suspicion of acute PE were retrospectively included in the study. In total, 25 of these patients had acute PE findings on CTA. DECT assessed perfusion defect volume (PDvol) were automatically and semiautomatically quantified. Overall, two CTA methods for risk assessment in patients with acute PE were assessed: the RV/LV diameter ratio and the Modified Miller obstruction score. Automatic PDvol had a weak correlation (r = 0.47, p = 0.02) and semiautomatic PDvol (r = 0.68, p < 0.001) had a moderate correlation to obstruction score in patients with confirmed acute PE, while only semiautomatic PDvol (r = 0.43, p = 0.03) had a weak correlation with the RV/LV diameter ratio. Our data indicate that PDvol assessed by DECT software technique may be a helpful tool to assess the severity of acute PE when compared to obstruction score and RV/LV diameter ratio. Full article
(This article belongs to the Special Issue Diagnostics of Pulmonary Embolism and Right Ventricular Dysfunction)
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