TITLE:
CT-Scan Evaluation of Acute Pulmonary Embolism: About 63 Thoracic CT-Angiographies at the Rock Medical Imaging Center (CIMR/Kinshasa)
AUTHORS:
Jean-Pierre Tshungu Muteleshi, Bibiche Nekanda Dongo, Christian Kabongo Wa Kabuya, Tacite Mazoba Kpanya, Dirk Ngoma Thenene, Patrick Anelia Lusilao, Diallo Bomane Isombeko, Xavier Tshabukole Munioka, Guillain Nsonde Nsiku, Michel Lelo Tshikwela, Antoine Molua Aundu, Jean Tshibola Mukaya
KEYWORDS:
Qanadli Score, Pulmonary Embolism, CT-Scan Thoracic, CT-Angiography, Kinshasa
JOURNAL NAME:
Open Access Library Journal,
Vol.10 No.10,
October
31,
2023
ABSTRACT: Background and objective: Pulmonary embolism (PE) is a serious pathology with high mortality. The clinical signs of pulmonary embolism are not very specific. Thoracic CT-angiography is the examination of choice in confirming the diagnosis of PE. Our objective was to describe the epidemiological-clinical, tomographic and progressive aspects of patients. Methods: A single-center descriptive and analytical observational study of a series of 63 patients received at the CIMR over a period of 24 months. Results: The incidence of acute pulmonary embolism was 25.6%. The average age of the patients was 66.5 ± 9.3 years with a F/M sex ratio of 1.6. Most patients had a PESI score ranging from I to III (31.8%, 28.6%, 19.1%). All patients with non-massive PE were stable, while 2 patients with massive PE (37.5%) died (p = 0.001). The Qanadli score (QS) was higher in the deceased (64.5% ± 2.1%) compared to the living (46% ± 11.8%) (p = 0.0313). The mean LV of patients with massive embolism was low compared to patients with non-massive embolism (p = 0.005). The pulmonary artery which was larger in patients with massive embolism (p = 0.007) compared to patients with non-massive embolism. The same for the aorta (p = 0.035). The RV/LV ratio was higher in patients with massive PE compared to stable patients (1.7 vs 1.1 p = 0.001). The sensitivity of an RV/LV ratio > 1 for the occurrence of massive PE was 91% with a specificity of 59%. Conclusion: The frequency of pulmonary embolism on CT-scan is high in our environment. The QS is high while the mean LV diameters of patients with massive embolism are low. The measurement of the pulmonary artery and aorta is greater in patients with massive embolism.