Department of Radio Diagnosis J. N. Medical College Belagavi
Acute pulmonary thromboembolism (PTE) is a critical cardiovascular condition with high mortality, especially when associated with right ventricular dysfunction (RVD). Computed tomography pulmonary angiography (CTPA) is the standard diagnostic tool for PTE, assessing thrombus burden and RVD indicators.This study aimed to determine the correlation between pulmonary embolism thrombus load, assessed using the Modified Miller Score (MMS), and RVD as demonstrated by CTPA. Additionally, it explored the relationship between thrombus load, CT signs, and 2D echocardiographic features of RVD.A prospective, hospital-based study was conducted over one year at Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi, involving 49 PTE patients undergoing CTPA and transthoracic echocardiography. CTPA scans were evaluated for PTE severity using MMS and RVD features.A significant association was observed between higher clot burden (MMS ?13) and RVD markers. Patients with MMS ?13 exhibited a positive RV/LV ratio in 69.39% (p = 0.0002), septal deviation in 30.61% (p = 0.0012), and a positive MPA/AA ratio in 65.31% (p = 0.0025). RA/RV enlargement was noted in 48.98% (p < 0>13 strongly correlated with RVD on CTPA (p < 0.01) and may serve as a predictor of RVD, facilitating faster diagnosis of PTE and right heart strain using CTPA alone.
Acute pulmonary thromboembolism (PTE) is a common disease which is potentially fatal and has a high mortality rate.The study was to determine correlation between increasing pulmonary embolism thrombus load and right ventricular (RV) dysfunction as demonstrated by CT pulmonary angiography (CTPA) and to determine the thrombus load threshold which indicates impending RV decomposition. To investigate any relationship between pulmonary thrombus load and 2D Echo features of right ventricular dysfunction. CTPA cannot only diagnose the embolism but also assess other underlying chest conditions that can result in similar clinical symptoms
MATERIALS AND METHODS:
Type of study: Prospective analytical observational study
Study duration: January 2024 to December 2024
Ethical committee approval: Obtained
Method of data collection:
Inclusion criteria: All patient ages >18 years undergoing CT pulmonary angiography for suspected PTE.
Exclusion criteria: Suboptimal scans and change of diagnosis
Study variables: Load of pulmonary thrombo embolism, short axes of RV/LV and MPA/AA ratio.
Statistical test: Chi-squaretest,Kolmogorov test, Shapiro-Wilk test, independent test
Modified Millers Score
Nivya Gudivada*, Virupaxi Hattiholi, An Analogy Between Clot Burden and Right Ventricular Dysfunction in Acute Pulmonary Thromboembolism on Computed Tomography Pulmonary Angiography Using Modified Millers Score: A One Year Hospital Based Cross Sectional Study, Int. J. Sci. R. Tech., 2025, 2 (4), 51-55. https://doi.org/10.5281/zenodo.15169127
10.5281/zenodo.15169127
