Reproducibility of Ventricular Diameter Ratio Measurements in Acute Pulmonary Embolism at an Academic Institution

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Vascular Disease Management


Purpose: The right ventricular short axis diameter–to–left ventricular short axis diameter (RV/LV) ratio can be a critical factor in determining whether intervention should be performed in a patient presenting with an acute pulmonary embolism, necessitating that this measurement is reproducible. We evaluate the reproducibility of RV/LV ratio measurements by residents and attending physicians at a large academic tertiary care hospital.

Materials and Methods: A retrospective analysis was performed for all patients at a large academic tertiary care institution who underwent catheter-directed thrombolysis for acute pulmonary embolism over a 2-year period. Patients were included in the study if they had a chest computed tomography angiography (CTA), were diagnosed with an acute pulmonary embolism, and underwent catheter-directed thrombolysis within 24 hours. The CTAs were retrospectively evaluated by two attending radiologists with 3 and 20 years of experience and one PGY-2 and one PGY-4 diagnostic radiology resident. All four physicians measured the cardiac chambers, adhering to standard measurement techniques, as described by Ghaye, Ghuysen, Bruyere, DOrio, and Dondelinger (2006).

Results: There were 97 patients meeting the inclusion criteria. The interrater reliability for the RV/LV ratio intraclass correlation coefficient was 0.86.

Conclusions: RV/LV ratio measurements were highly reproducible between and among residents and attending physicians, supporting the use of these measurements as a criterion for risk stratification of patients with pulmonary embolism requiring catheter-directed thrombolysis.