The rate of resolution of clot burden measured by pulmonary CT angiography in patients with acute pulmonary embolism.
The rate of resolution of clot burden measured by pulmonary CT angiography in patients with acute pulmonary embolism.
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DOI：
10.2214/ajr.12.8624
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Bae KT
中科院分区：
文献类型：
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作者：
Aghayev A;Furlan A;Patil A;Gumus S;Jeon KN;Park B;Bae KT
本文旨在定量评估急性肺栓塞（PE）患者肺CT血管造影（CTA）检测到的凝块负荷的消退率。我们在回顾性队列中评价了111例连续患者（55例男性和56例女性），这些患者通过肺CTA诊断为PE，并且在1年内至少进行了一次随访肺CTA。两名放射科医生一致使用半自动定量程序测量每个凝块的体积。还计算了血凝块负荷的半定量测量。分析了总血凝块体积以及中央（主和肺叶）和外周血管（节段和亚节段）的血凝块体积的消退率。每项研究的平均（± SD）血凝块体积在基线时为3403.3 ± 6505.6 mm 3，在随访肺CTA时为531.6 ± 2383.5 mm 3。总体而言，85例患者（77%）在随访肺CTA时显示完全消退。在1-14天的随访间隔内，30例患者中有17例（56.7%）完全消退，31例患者中有24例（77.4%）在29-90天完全消退，34例患者中有32例（94.1%）在90天后完全消退。所有患者的总血凝块体积测量值在第14天时减少78%（中心血凝块，69.4%;外周血凝块，86.0%），在第90天时减少96.6%（中心血凝块，93.4%;外周血凝块，100%），在第90天时减少97.7%（中心血凝块，95.9%;外周血凝块，100%）。随访期间，77%的患者的凝块负荷完全消退。我们的分析表明，血栓在外周动脉中比在中央肺动脉中溶解得更快。
The purpose of this article is to quantitatively assess the rate of resolution of clot burden detected on pulmonary CT angiography (CTA) in patients with acute pulmonary embolism (PE). We evaluated 111 consecutive patients (55 men and 56 women) in a retrospective cohort who were diagnosed with PE by pulmonary CTA and had at least one follow-up pulmonary CTA within 1 year. Two radiologists in consensus measured the volume of each clot using a semiautomated quantification program. Semiquantitative measures of clot burden were also computed. The resolution rates of the total clot volume, as well as clot volumes of the central (main and lobar) and peripheral vessels (segmental and subsegmental), were analyzed. The mean (± SD) clot volume per study was 3403.3 ± 6505.6 mm3 at baseline and 531.6 ± 2383.5 mm3 at the follow-up pulmonary CTA. Overall, 85 patients (77% ) showed complete resolution at the follow-up pulmonary CTA. Complete resolution was seen in 17 of 30 patients (56.7%) at a follow-up interval of 1–14 days, in 24 of 31 patients (77.4%) at 29–90 days, and in 32 of 34 patients (94.1%) after 90 days. The total clot volume measurements summed for all patients decreased by 78% (central clot, 69.4%; peripheral clot, 86.0%) at 14 days, by 96.6% (central clot, 93.4%; peripheral clot, 100%) at 90 days, and by 97.7% (central clot, 95.9%; peripheral clot, 100%) after 90 days. Clot burden resolved completely in 77% of patients during the follow-up period. Our analysis showed that clots resolved faster in the peripheral arteries than in the central pulmonary arteries.