Evaluation of Inferior Vena Cava/Abdominal Aorta Diameter Index in Pulmonary Embolism

Abstract

Aim: Among cardiovascular diseases, pulmonary embolism (PE) is a serious emergency with high mortality. Right ventricular dysfunction due to an excessive increase in pulmonary artery pressure is considered a major cause of death in vigorous PE. We aimed to assess the predictive value of computed tomographic pulmonary angiography (CTPA)-based morphometric measurements of right heart function in the diagnosis of PE.

Materials and Methods: This is a retrospective, case-controlled study. A total of 198 cases were included in the study during the study phase. CTPA results of 102 patients with PE were recorded, and the patients were grouped according to clot localisation. The diameters of the inferior vena cava (IVCA), aorta, pulmonary artery and right and left ventricles were assessed.

Results: IVCA area/aortic area significantly predicted embolism in the main pulmonary artery [area under the curve (AUC)=0.957, p<0.001]. The optimal cut-off value was 1.22 with 88% sensitivity and 90% specificity. IVCA diameter/aortic diameter significantly predicted embolism in the main pulmonary artery (AUC=0.955, p<0.001). The optimal cut-off value was 1.1 with 89% sensitivity and 88% specificity.

Conclusion: Our study illustrated a remarkable association between the existence and dispersion of PE and morphometric changes in IVCA and aortic ratio parameters measured using CTPA.