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Acute Pulmonary Embolism on MDCT of the Chest: Prediction of Cor Pulmonale and Short-Term Patient Survival from Morphologic Embolus Burden

Christoph Engelke1, Ernst J. Rummeny1 and Katharina Marten1

1 All authors: Department of Radiology, Klinikum rechts der Isar, Technical University Munich, Ismaningerstrasse 22, Munich 81675, Germany.


Figure 1
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  		Fig. 1A —80-year-old woman with clinically suspected pulmonary embolism and evidence of major pulmonary embolism involving left main and intermediate arteries, left lower lobe artery, and left segmental branches 3 and 8-10 (arrows). Miller I and II scores and Mastora score were 56.3%, 25%, and 21.3%, respectively, for reviewer 1 and 50%, 25%, and 24.5%, respectively, for reviewer 2. Cor pulmonale was evident on transthoracic echocardiography, and patient underwent systemic thrombolysis. However, she died on third day after diagnosis from cardiogenic shock.

 

Figure 2
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  		Fig. 1B —80-year-old woman with clinically suspected pulmonary embolism and evidence of major pulmonary embolism involving left main and intermediate arteries, left lower lobe artery, and left segmental branches 3 and 8-10 (arrows). Miller I and II scores and Mastora score were 56.3%, 25%, and 21.3%, respectively, for reviewer 1 and 50%, 25%, and 24.5%, respectively, for reviewer 2. Cor pulmonale was evident on transthoracic echocardiography, and patient underwent systemic thrombolysis. However, she died on third day after diagnosis from cardiogenic shock.

 

Figure 3
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  		Fig. 1C —80-year-old woman with clinically suspected pulmonary embolism and evidence of major pulmonary embolism involving left main and intermediate arteries, left lower lobe artery, and left segmental branches 3 and 8-10 (arrows). Miller I and II scores and Mastora score were 56.3%, 25%, and 21.3%, respectively, for reviewer 1 and 50%, 25%, and 24.5%, respectively, for reviewer 2. Cor pulmonale was evident on transthoracic echocardiography, and patient underwent systemic thrombolysis. However, she died on third day after diagnosis from cardiogenic shock.

 

Figure 4
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  		Fig. 1D —80-year-old woman with clinically suspected pulmonary embolism and evidence of major pulmonary embolism involving left main and intermediate arteries, left lower lobe artery, and left segmental branches 3 and 8-10 (arrows). Miller I and II scores and Mastora score were 56.3%, 25%, and 21.3%, respectively, for reviewer 1 and 50%, 25%, and 24.5%, respectively, for reviewer 2. Cor pulmonale was evident on transthoracic echocardiography, and patient underwent systemic thrombolysis. However, she died on third day after diagnosis from cardiogenic shock.

 

Figure 5
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  		Fig. 1E —80-year-old woman with clinically suspected pulmonary embolism and evidence of major pulmonary embolism involving left main and intermediate arteries, left lower lobe artery, and left segmental branches 3 and 8-10 (arrows). Miller I and II scores and Mastora score were 56.3%, 25%, and 21.3%, respectively, for reviewer 1 and 50%, 25%, and 24.5%, respectively, for reviewer 2. Cor pulmonale was evident on transthoracic echocardiography, and patient underwent systemic thrombolysis. However, she died on third day after diagnosis from cardiogenic shock.

 

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