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Abstract

BACKGROUND: Acute pulmonary embolism (PE) is an important, life threatening clinical issue and early diagnosis and treatment is essential to improve patient outcome and save life. Nowadays, computed tomography pulmonary angiogram (CTPA) represents the frontline investigation for detection of    PE down to sub segmental pulmonary arteries. OBJECTIVE: To evaluate the role of descending aorta to main pulmonary artery (DA/MPA) density ratio as            a predictor for the outcome of patients with acute PE using CTPA. METHOD: This is a prognostic prospective study conducted on 25 patients with mean age 45 years ± (range 17-73 years) in AL-Najaf center for cardiac surgery and trans-catheter therapy, AL-Najaf, Iraq.                The DA/MPA density ratio, main pulmonary artery (PA) diameter and right ventricular: left ventricular (RV:LV) ratio were measured on axial sections on CTPA unit and then correlated with patients’ outcome (hospitalization stay, complications and death) and then statistically assessed . RESULTS: Twenty five patients (sixteen females and nine males) with acute PE were included in this study. The acute PE is classified into massive (no = 15 patients) and sub massive (no = 10 patients) according to clinical state of patient (10) (30). There was weak correlation between DA/MPA density ratio and outcome of patients (p=0.2 and r=0.3) while PA diameter and RV:LV ratio  showed stronger correlation (p=0.003 and r=0.6) and (p=0.01 and r=0.5) respectively. No death was reported. CONCLUSION: Compared to main PA diameter and RV:LV ratio, the DA/MPA density ratio is not so useful in predicting the outcome of patients with acute PE up to one month follow up. However further studies with longer follow up time are suggested.  

DOI

10.52573/ipmj.2023.181213

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