Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

Abstract

Bowing of the interventricular septum (IVS) is a sign of severe pulmonary embolism (PE); however, it is affected by high interobserver variability. The aim of the study was to evaluate the application of volumetric reconstructions of the right ventricle for assessment of IVS position regarding its accuracy in identifying right ventricular dysfunction, as well as interobserver agreement in evaluating this sign. IVS bowing was evaluated with multiplanar reformations (MPR) and volumetric reconstruction (VR, volume rendering) by 2 observers. The accuracy of IVS bowing sign was better for VR-based assessment; however, it was not significantly better than the MPR-based evaluation. Interobserver agreement was found to PE. (Folia Morphol 2013; 72, 2: 107-112)

Prognostic Role of Ct Pulmonary Angiography in Acute Pulmonary Embolism

“…Ventricular septum bowing is affected by the plane of detection & by septal movements through the cardiac cycle in "non-gated" CT, which explains the low sensitivity (29) . Retrograde opacification of the IVC & hepatic veins could be encountered many times during CTPA (figure 8).…”