• Azin Shayganfar, Somayeh Hajiahmadi, Mohsen Astaraki, and Shadi Ebrahimian.
• Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
• Int J Emerg Med. 2020 Apr 3; 13 (1): 15.

BackgroundThis study was conducted to detect the association between radiologic features of CT pulmonary angiography (CTPA) and pulmonary embolism severity index (PESI).MethodsA total of 150 patients with a definite diagnosis of PE entered the study. The CTPA feature including obstruction index, pulmonary trunk size, presence of backwash contrast, septal morphology, right ventricular (RV) and left ventricular (LV) dimensions, and RV/LV ratio were examined. The severity of the PE was estimated using PESI. The association between CTPA indices and PESI was measured. Statistical analysis was conducted using the SPSS software. P value < 0.05 was considered as statistically significant.ResultsA positive correlation was detected between the obstruction index and PESI (r = 0.45, P < 0.05). Moreover, PESI was significantly higher in patients with a more dilated pulmonary trunk (r = 0.20, P < 0.05). The backwash contrast and abnormal septal morphology were significantly more common among patients with higher PESI (P < 0.05). However, no significant correlation was detected between RV, LV, RV/LV, and PESI. The most predictor of high-risk PE was dilated pulmonary trunk with an odds ratio of 4.4.ConclusionHigher Obstruction index, dilated pulmonary trunk, presence of backwash contrast, and an abnormal septal morphology can be associated with a higher PESI.

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