Objective: To compare the value of Qanadli versus Mastora pulmonary embolism index in evaluating straddle-type pulmonary embolism by computed tomography (CT).
Methods: The clinical data were collected for 38 hospitalized patients with straddle-type pulmonary embolism diagnosed by CT pulmonary angiography (CTPA) from January 2011 to May 2014. There were 20 males and 18 females with an average age of (59.2 ± 17.4 years). And the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and D-dimer were recorded. And Qanadli and Mastora pulmonary embolism indices were used to independently determine the CT embolism indices. Difference and correlation between Quandli and Mastora pulmonary embolism index were analyzed. And the relations between Qanadli score, Mastora score and serum parameters and right heart function parameters were analyzed.
Results: Qanadli score of 38 patients was 20.0 ± 0.0 while Mastora score 80.9 ± 26.1. No significant correlation existed between Qanadli and Mastora scores. Median serum D-dimer level was 708.5 (9.6, 1 025.5) µg/L and median NT-proBNP 1 358.5 (576.7, 3 047.3) ng/L. Qanadli score was not statistically significantly correlated with serum D-dimer or NT-proBNP level. Mastora score was not correlated with serum D-dimer level statistically significantly, but it was positively correlated with the level of NT-proBNP (r = 0.495, P = 0.010). No significant correlation existed between Qanadli score and right atrial diameter, right ventricular/left ventricular diameter ratio on CTPA. Mastora score was positively correlated with right atrial diameter/left atrial diameter ratio (r = 0.627, P < 0.001) and right ventricular diameter/left ventricular diameter ratio on CTPA (r = 0.628, P < 0.001). The Mastora score was not significantly correlated with main pulmonary artery diameter and main pulmonary artery diameter/ascending aorta diameter ratio on CTPA.
Conclusions: Mastora pulmonary embolism index is better than Qanadli pulmonary embolism index in evaluating straddle-type pulmonary embolism. Correlated with right ventricular function, the former reflects pulmonary embolic load and change of right heart function.