Abstract
Objectives: Pulmonary thromboembolism (PTE) is an emergent disease with high mortality. Wells and revised Geneva scores are commonly used probability scales in PTE diagnosis. Computed tomography pulmonary angiography (CTPA) is the radiological diagnostic method. We aimed to determine computed tomography pulmonary arterial obstruction index ratio (CTPAOIR) which indicates degree and the extent of the thrombotic pulmonary arterial occlusion and compare Wells and revised Geneva scale with CTPAOIR, parenchymal enfarct and pleural effusion.
Material and Methods: CTPA was performed to 69 patients with the prediagnosis of PTE by using 6-slice multidetector CT scanner (Philips, Netherland). Patients were divided into three groups as high, intermediate and low risk groups according to Wells and revised Geneva scores. Patients with PTE were regrouped and CTPAOIR, pleural effusion and parenchymal infarct presence were compared.
Results: In the present study 50 (72.5%) of 69 patients had PTE diagnosis. While no significant correlation was found between CTPAOIR and pleural effusion presence had no significant correlation with Wells clinic scores (p > 0.05), CTPAOIR and parenchyml infarct presence had significant correlation (p = 0.044). No correlations between CTPAOIR, pleural effusion and parenchyml infarct presence with revised Geneva scores were found (p > 0.05). CTPAOIR was significantly correlated with pleural effusion and parenchymal infarct presence (p = 0.040 vs p = 0.002). There were no significant differences among patient groups according to Wells and revised Geneva scores in terms of CTPAOIR (p > 0.05).
Conclusions: We determined the increased probability of parenchymal enfarct with higher Wells scores. Parenchymal enfarct and pleural effusion in CTPA may indicate the presence of PTE in subsegmental and/or distal pulmonary arteries.
Keywords: Pulmonary thromboembolism, computed tomography pulmonary angiography, wells score, revised geneva score.
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