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T-pulmonary angiography (CTPA) is routinely performed in patients with suspected pulmonary embolism (PE) and a positive relationship between Qanadli score (Q-score) and RV dysfunction enables the clinicians in early diagnosis and management of RV-dysfunction on the basis of this single imaging modality. Our study was carried on 24 patients with suspected acute PE. This study aimed to investigate the correlation of computerized tomography pulmonary angiography-based parameters as pulmonary artery obstruction index (PAOI) which was calculated according to Qanadli score, pulmonary artery diameter as well as right ventricular diameters for pulmonary embolism (PE) risk evaluation and prediction of mortality and intensive care unit (ICU) requirement.
The study showed that there was highly statistically significant difference between Qandli and RV/LV ratio, PA diameter, IVS deviation to left, ECHO (RVD) and outcome.
ROC analysis was used to define the best cut off point for Qanadli score as a predictor for echo results which was found > 27.5 with sensitivity of 100%, specificity of 81.25% and area under curve (AUC) of 94.5% and the best cut off point for Qanadli score as a predictor for outcome of the studied patients was found > 42.5 with sensitivity of 71.43%, specificity of 88.24% and area under curve (AUC) of 80.3%.
Clot burden as determined by Qanadli score correlates strongly and positively with indicators of RV dysfunction on CT Pulmonary Angiogram and can be used to predicate a higher mortality risk and guide treatment accordingly in patients with acute pulmonary embolism so PE scoring and the CT cardiac changes must be essential points in our radiology reports of PE cases.