CTPA vessel density predicts mortality in PE patients

Wednesday, December 4 | 11:20 a.m.-11:30 a.m. | SSK06-06 | Room S103AB

High pulmonary artery density on CT pulmonary angiography (CTPA) scans was associated with an increased risk of death in patients with pulmonary embolism (PE) in this study to be presented on Wednesday.

Recent research has identified a potential link between high attenuation values on CTPA scans and reduced cardiac output, which is one of the primary causes of death from acute PE. Principal investigator Dr. Dan Shilo and colleagues from the Warren Alpert Medical School at Brown University set out to determine whether CTPA attenuation values might also be associated with mortality in patients with PE.

To that end, the group obtained the CTPA scans of 1,000 patients confirmed to have PE between January 2017 and February 2019. Then the researchers measured the densities of the main pulmonary artery, superior vena cava, left atrium, and descending aorta on a single axial chest CT scan.

The patients who died from PE within the first 30 days after initial examination had much higher attenuation in the pulmonary artery than those who survived (p < 0.0001), they found. In addition, those who died also had a considerably greater attenuation difference between the main pulmonary artery and the descending aorta (p = 0.001), compared with those who lived.

Measuring vessel densities on single midthoracic axial CTPA scans offers a novel approach to identifying high-risk PE patients, Shilo told AuntMinnie.com.

"The results of the current study may improve risk stratification of patients presenting with acute pulmonary embolism and guide appropriate clinical management," he said.