Multi-slice Spiral CT And Dual-energy Revolution CT Multi-parameter Assessment Of Acute Pulmonary Embolism Risk

Part I: Application value of multi-slice spiral CT multiparameter in risk stratification of acute pulmonary embolism Objective: To investigate the diagnostic value of Multi-slice spiral CT（MSCT）multiparameter in the risk stratification of acute pulmonary embolism（APE）.Methods:A total of 74 patients diagnosed with APE by MSCT in the First Affiliated Hospital of Bengbu Medical College from January 2019 to October 2020 were enrolled and divided into high-risk group（18 cases）,medium-high risk group（26 cases）and medium-low risk group（30 cases）according to their hemodynamic status,right ventricular function and myocardial injury.The differences of PAOI and other imaging parameters,clinical and laboratory indicators among groups were compared.The predictive value of PAOI and cardiovascular parameters for high-risk and medium-high risk patients was evaluated by using the subject operating characteristic curve.The independent risk factors of APE patients in high-risk or medium-high-risk groups were analyzed by multiple ordered Logistic regression.Results:Statistically significant differences were found in LDH,PAOI,PTD,PTD/AAD,RVD/LVD and involvement of pulmonary segmental arteries in different groups of patients（P<0.001）.The sensitivity and specificity of PAOI（>38.8%）for assessing patients at high-risk and medium-high risk of APE were 65.9% and 80.0%,respectively;and PAOI values are an independent risk factor for patients at high-risk or medium-high risk of APE（p<0.001）.the sensitivity and specificity of RVD/LVD（>1.2）and PTD/AAD（>0.9）for assessing patients at high-risk and medium-high risk of APE were 59.1% and 93.3%,65.9% and 86.7%,respectively.Conclusion: MSCT multi-parameters may be used to assess the severity and predict the progression of APE patients and guide clinical treatment.