Background:
Chronic pulmonary thromboembolism (CTEPH) is an unusual complication of acute pulmonary embolism (PE), which is now considered treatable. In modern multi-detector scanners, a detailed evaluation of pulmonary artery geometry is currently possible. This study aimed to evaluate Pulmonary Artery Bifurcation Angle (PABA) changes in the follow-up computed tomography angiography (CTA) of patients with acute PE.
Methods:
In this cross-sectional study, the records of two tertiary-level academic hospitals were gathered from 2012 to 2019. Pulmonary Artery (PA) bifurcation angle and diameter were measured. Chi-Square test, independent samples T-test, Mann-Whitney, and pearson’s tests were employed to compare data. We utilized receiver operating characteristic analysis to evaluate the cut-off point (ROC) curve. Pulmonary artery bifurcation angle changes’ accuracy, sensitivity, and specificity were calculated. A P value <0.05 was considered to be significant.
Results:
Forty-Six patients were included in the study. No significant differences were found between patients with and without CTEPH and PABA in the dimeters of PA trunk, right PA, and left PA in the first CTA images (P Values Of 0.151, 0.142, 0.891, and 0.483, respectively). At the same time, In the secondary CTA, the mean PABA was significantly smaller in patients with CTEPH (P=0.011). In the receiver operating characteristic (ROC) analysis, delta angle revealed an area under the curve Of 0.745 and an optimal cutoff of 0, leading to a sensitivity of 64%, specificity of 87%, and accuracy of 76% for diagnosing CTEPH.
Conclusion:
We showed s significant decrease in PABA in patients developing CTEPH. this parameter can be easily measured in lung CTA.