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

Folia Morphol (Warsz). 2013 May;72(2):107-12. doi: 10.5603/fm.2013.0018.

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 be fair (kappa = 0.381) for the MPR-based grading of IVS position as normal orabnormal, while it was significantly better for the VR method (kappa = 0.629,p < 0.001). The VR-based method may improve utilisation of IVS bowing sign inpatients with PE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / pathology
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Pulmonary Embolism / complications*
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / pathology
  • Radiographic Image Interpretation, Computer-Assisted
  • Tomography, X-Ray Computed
  • Ventricular Septum / diagnostic imaging*
  • Ventricular Septum / pathology