ObjectiveTo investigate the value of iodine base values of the hypoperfusion zone measured by dual-energy computerized tomography (DECT) in the assessment of risk stratification for acute pulmonary embolism (APE).

MethodsThe clinical and imaging data of 57 patients with APE were retrospectively analyzed, and the iodine base values of the hypoperfusion area and other related parameters were measured on DECT images. The patients with APE were divided into a high-risk group (20 patients) and a non-high-risk group (37 patients) according to the hemodynamic status. The differences in radiological parameters such as the low perfusion zone iodine base value and clinical parameters were compared between the two groups.

ResultsThere was a statistically significant between high-risk and non-high-risk APE patients with age, deep vein thrombosis (DVT), pulmonary trunk diameter/ascending aortic diameter, the diameter of right ventricle (RVD)/the diameter of left ventricle (LVD), pulmonary artery obstruction index (PAOI) and iodine base values in the low perfusion zone (P < 0.05 to P < 0.01). Logistic regression analysis showed that age, DVT, RVD/LVD and PAOI were all independent risk factors for the development of high risk in patients with APE (P < 0.05 to P < 0.01).

ConclusionsIodine base values in the low perfusion zone are helpful to assess the severity of APE patients and to guide clinical treatment for the benefit of patients.