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Purpose <p>This study aimed to evaluate the predictive value of inferior vena cava (IVC) reflux and the right ventricle to left ventricle ratio (RV/LV ratio) in risk stratification of acute pulmonary thromboembolism (APTE) patients.</p> Methods <p>In this retrospective, cross-sectional study, eighty-six patients diagnosed with APTE underwent computed tomography pulmonary angiography (CTPA). The pulmonary arterial obstruction index (Qanadli score) was evaluated by an experienced radiologist, along with the RV/LV ratio and IVC reflux grading (1–6) based on CTPA. Correlations between the Qanadli score, IVC reflux grade, and RV/LV ratio were analyzed. Linear regression was performed after confirming regression assumptions. Additionally, IVC reflux grade and Qanadli score were compared between patients with RV/LV ratios below and above 0.9.</p> Results <p>The mean Qanadli score was 7.20 ± 8.04. A significant correlation was found between the Qanadli score and IVC reflux grade (<i>r</i> = 0.601, <i>p</i> &lt; 0.001), whereas no significant correlation was observed between the Qanadli score and RV/LV ratio (<i>r</i> = 0.131, <i>p</i> = 0.230). Further analysis demonstrated a significant linear association between the Qanadli score and IVC reflux grade, with a regression coefficient of 3.98 ± 0.55 (<i>p</i> &lt; 0.001) and an adjusted R² of 0.38. However, patients with an RV/LV ratio &gt; 0.9 did not show a significant difference in IVC reflux grade (<i>p</i> = 0.176) or Qanadli score (<i>p</i> = 0.439).</p> Conclusion <p>Our study highlights IVC reflux as a potential valuable imaging marker for assessing APTE severity, while also pointing out the limitations of relying solely on the RV/LV ratio for risk stratification.</p>

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Evaluating inferior vena cava reflux and RV/LV ratio as predictors of acute pulmonary thromboembolism severity

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月2日

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  • Ehsan Goudarzi,
  • Diba Akbarzadeh,
  • Saba Aghajani,
  • Mohammad Amin Sabbagh Alvani,
  • Taraneh Faghihi Langroudi,
  • Isa Khaheshi

摘要

Purpose

This study aimed to evaluate the predictive value of inferior vena cava (IVC) reflux and the right ventricle to left ventricle ratio (RV/LV ratio) in risk stratification of acute pulmonary thromboembolism (APTE) patients.

Methods

In this retrospective, cross-sectional study, eighty-six patients diagnosed with APTE underwent computed tomography pulmonary angiography (CTPA). The pulmonary arterial obstruction index (Qanadli score) was evaluated by an experienced radiologist, along with the RV/LV ratio and IVC reflux grading (1–6) based on CTPA. Correlations between the Qanadli score, IVC reflux grade, and RV/LV ratio were analyzed. Linear regression was performed after confirming regression assumptions. Additionally, IVC reflux grade and Qanadli score were compared between patients with RV/LV ratios below and above 0.9.

Results

The mean Qanadli score was 7.20 ± 8.04. A significant correlation was found between the Qanadli score and IVC reflux grade (r = 0.601, p < 0.001), whereas no significant correlation was observed between the Qanadli score and RV/LV ratio (r = 0.131, p = 0.230). Further analysis demonstrated a significant linear association between the Qanadli score and IVC reflux grade, with a regression coefficient of 3.98 ± 0.55 (p < 0.001) and an adjusted R² of 0.38. However, patients with an RV/LV ratio > 0.9 did not show a significant difference in IVC reflux grade (p = 0.176) or Qanadli score (p = 0.439).

Conclusion

Our study highlights IVC reflux as a potential valuable imaging marker for assessing APTE severity, while also pointing out the limitations of relying solely on the RV/LV ratio for risk stratification.