Volumetric evaluation of dual-energy perfusion CT by the presence of intrapulmonary clots using a 64-slice dual-source CT.
This study was approved by the local ethics committee.ResultsPA pressure and D-dimer were significantly higher in the patients who had IPCs. In the patients with IPCs, V15, V10, V5, %V15, %V10, and %V5 were also significantly higher than those without IPC (P ≤ 0.001). %V5 had a better correlation with D-dimer (r = 0.30, P
A 64-year-old woman with a history of cirrhosis and progressive difficulty breathing underwent pulmonary ventilation/perfusion SPECT to evaluate possible pulmonary embolism. The images demonstrated multiple mismatched ventilation/perfusion defects in both lungs, suggesting pulmonary embolism. However, there was also 99mTc-MAA radioactivity in the brain and bilateral kidney, with a right-to-left shunting rate of 8.8%. In addition, CT pulmonary angiography did not demonstrate embolus. The findings indicated that perfusion defects were caused by hepatopulmonary syndrome.
CONCLUSIONS: Increased VD/VT at anaerobic threshold and decreased stroke volume reserve during exercise are common among patients with dyspnea on exertion after long-term treatment of PE. The defects can be disclosed noninvasively by cardiopulmonary exercise testing. PMID: 31759962 [PubMed - as supplied by publisher]
Introduction: The prevalence of pulmonary embolism (PE) in patients that present to the Emergency Department (ED) with isolated syncope is unclear. Conflicting results were recently reported with a prevalence ranging from less than 1% to up to 17%. However, these studies included patients that may also have had other symptoms suggestive of PE (chest pain or dyspnea), or patients that had no systematic assessment for the presence of PE. Since a low prevalence (
Backgrounds: Chronic thromboembolic disease (CTED) is characterized by similar symptoms and perfusion defect as chronic thromboembolic pulmonary hypertension (CTEPH), but without pulmonary hypertension at rest. Recently, successful pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA) for symptomatic patients with CTED has been reported. However, it remains unclear whether CTED evolves to CTEPH. The aim of this study is to clarify the natural history of CTED.Methods: Consecutive patients diagnosed as CTED between 1986 and 2017 were retrospective enrolled. CTED was defined as follows: a mean pulmonary arterial pressure at rest
ConclusionsSerum ionized calcium may be an indicator of pulmonary embolism in patients with primary lung cancer.
ConclusionWarm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine donor model.
Conclusion In our sample of patients with isolated syncope, the prevalence of pulmonary embolism was 2.2%. This value is not sufficiently low to negate the requirement for a formal work up in the ED, even in the absence of chest pain or dyspnea. However, the large confidence interval precludes any strong conclusion.
Parang S Sanghavi, Bhavin G JankhariaIndian Journal of Radiology and Imaging 2019 29(3):289-298 In dual-energy CT (DECT), two different x-ray spectra are used to acquire two image datasets of the same region, to allow the analysis of energy-dependent changes in the attenuation of different materials. Each type of material demonstrates a relatively specific change in attenuation between images obtained with a high-energy spectrum and those obtained with a low-energy spectrum. Based on the relatively specific change in attenuation with two different energies, material composition information can be obtained to allow tissue ...
Surviving an embolism exposes patients to potential long-term complications, such as altered quality of life, persistent dyspnea, impaired exercise capacity or pulmonary hypertension. The common objective factor in most of these situations is the presence of residual pulmonary vascular obstruction (RPVO). Planar ventilation/perfusion scintigraphy (V/Q lung scan) is the gold standard for assessing RPVO, which occurs in 46 to 66% of patients at 3 months and persists in 25 to 29% of patients a year after acute PE.
AbstractRed blood cell distribution width (RDW) is a marker of variability in red blood cell size, and is routinely reported as part of a patient ’s complete blood count. RDW has been shown to be associated with the prediction, severity and prognosis of pulmonary embolism (PE) in recent studies. The underlying biomolecular mechanism of the relationship of RDW to PE is largely unknown, but is thought to be due to the relationship of RDW with acute inflammatory markers and variations in blood viscosity. This review substantiates that a high RDW level, defined using either an arbitrary number or according to receiver op...