Contrast circulation time to assess right ventricular dysfunction in pulmonary embolism: a retrospective pilot study

Objective: To optimize enhancement of pulmonary arteries and facilitate diagnosis of pulmonary embolism (PE), modern computed tomography angiography (CTA) contains a contrast bolus tracking system. We explored the diagnostic accuracy of the time-intensity curves given by this automated system to identify right ventricular dysfunction (RVD) in acute PE.
Methods: 114 CTAs with a diagnosis of PE were reviewed. RVD was defined as right-to-left ventricular diameter ratio of 1 or greater. Four parameters on time-intensity curves were identified. Parameters between CTAs with and those without RVD were compared with the Wilcoxon rank-sum test. The ability of the four parameters to discriminate patients with RVD was explored by compiling the area under the operating curves (AUC).
Results: The time needed by the contrast media to reach the pulmonary artery [8 seconds (IQR: 7-9) versus 7 seconds (IQR: 6-8), p<0.01], the time needed to reach 40 Hounsfield units (HU) [11 seconds (IQR: 8.5-14...

研究目的：为优化肺动脉增强效果、辅助肺栓塞（pulmonary embolism, PE）诊断，现代计算机断层血管造影（computed tomography angiography, CTA）配备了对比剂跟踪系统。本研究探讨该自动化系统生成的时间-强度曲线，在急性肺栓塞患者右心室功能障碍（right ventricular dysfunction, RVD）诊断中的准确性。
方法：回顾性分析114例经确诊为肺栓塞的CTA影像资料。本研究以右心室与左心室直径比值≥1作为右心室功能障碍的判定标准。提取时间-强度曲线的四项参数，采用Wilcoxon秩和检验对比存在与不存在右心室功能障碍患者的各项参数差异。通过绘制受试者工作特征曲线下面积（area under the operating curves, AUC），评估四项参数鉴别右心室功能障碍患者的诊断效能。
结果：对比剂抵达肺动脉所需时间[8秒（四分位距：7-9）vs 7秒（四分位距：6-8），p<0.01]、对比剂升至40亨氏单位（Hounsfield units, HU）所需时间[11秒（四分位距：8.5-14...