Considered 2 nd commonest pattern.
Rv lv ratio ct.
Quantitative cardiac ct measurements obtained on axial ct images namely the rv short axis the lv short axis and particularly the rv lv short axes ratio have shown a significant positive rv short axis rv lv diameter ratio or negative lv short axis correlation with the severity of pe 37 or with fatal outcome 38 39 fig 2.
Neither rv lv diameter ratio nor embolic burden was associated with increased risk of death.
For observer 3 vsb was associated with death in univariate or 2 10.
Normal ct rv lv ratio plus readily obtained five clinical predictors were adequate to exclude rv strain or pe related short term mortality.
In this study cohort a high proportion of patients had ph 78.
Pvr 2 8 1 8 3 1 wood.
Ct depicted vsb is predictive of death due to pe but with low sensitivity and high interobserver variability.
May have a role in assessment.
This study found that compared with the gold standard transthoracic echo tte ct sensitivity for rv strain was 88 specificity 39 ppv 49 and npv 83.
Of 80 patients with an rv lvlargest ratio 1 0 16 20 had borderline ph mpap 21 16 23 mm hg.
Flattening of the interventricular septum.
Abnormal position of the interventricular septum 1.
Towards the left ventricle.
Of 80 patients with an rv.
The rv lv ratio had poor specificity in detecting ph at rhc however suggesting that the rv lv ratio at ct imaging cannot be relied on to exclude ph.
P 05 and multivariate analyses or 2 18.
In this study cohort a high proportion of patients had ph 78.
Although axial and four chamber rv lv diameter ratios.
If these five factors were all absent 37 1 of the population the probability that ct rv lv ratio is sufficient to exclude rv strain pe related short term death was 0 97 95 ci 0 95 0 99.
A follow up study by the same group found that an el evated four chamber rv lv diameter ratio was a significant predictor of 30 day all cause mortality in 431 patients with pe.
Ct pe rv lv ratio pert workflow calculators adrenal ct adrenal mr ecv cv aorta arvc criteria chamber sizes coronary calcium watchman thoracic covid 19 fleischner 2017 uip gi pancreatic cyst pancreatitis gu renal cyst bosniak ultrasound ob ultrasound ovarian cyst thyroid nodules rads li rads v2018 lung rads v1 1 2019 pi rads v2 0 2015 ti.
The reported sensitivity and specificity of ct in demonstrating right heart dysfunction are around 81 and 47 respectively 5.
Paradoxical interventricular septal bowing i e.
The rv lv ratio had poor specificity in detecting ph at rhc however suggesting that the rv lv ratio at ct imaging cannot be relied on to exclude ph.
Volume overload plus left ventricular dysfunction.
Rv lv ratio 0 9 rv strain ct pulmonary angiogram ctpa can not only visualize the clot but can also detect evidence of rv strain.
Depressed biventricular function.
