Tuberculosis and Respiratory Diseases

  • 제81권1호
  • /
  • Pages.49-58
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  • 2018
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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Detection of Deep Vein Thrombosis by Follow-up Indirect Computed Tomography Venography after Pulmonary Embolism

  • Lee, Hye Jin (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cha, Seung-Ick (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Shin, Kyung-Min (Department of Radiology, Kyungpook National University School of Medicine) ;
  • Lim, Jae-Kwang (Department of Radiology, Kyungpook National University School of Medicine) ;
  • Yoo, Seung-Soo (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Shin-Yup (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Jaehee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Chang-Ho (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Jae-Yong (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • 투고 : 2016.08.23
  • 심사 : 2017.05.29
  • 발행 : 2018.01.31
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초록

Background: Information regarding the incidence and risk factors for deep vein thrombosis (DVT) detected by follow-up computed tomographic (CT) venography after pulmonary embolism (PE) is sparse. The aim of the present study was to identify the predictors of DVT in follow-up CT images, and to elucidate their clinical significance. Methods: Patients with PE were classified into the following three cohorts based on the time of indirect CT venography follow-up: within 1 month, 1 to 3 months, and 3 to 9 months after the initial CT scan. Each cohort was subdivided into patients with or without DVT detected by follow-up CT. Clinical variables were compared between the two groups. Results: Follow-up CT revealed DVT in 61% of patients with PE within 1 month, in 15% of patients with PE at 1 to 3 months, and in 9% of patients with PE at 3 to 9 months after the initial CT scan. Right ventricular (RV) dilation on the initial CT (odds ratio [OR], 8.30; 95% confidence interval [CI], 1.89-36.40; p=0.005) and proximal DVT at the initial presentation (OR, 6.93; 95% CI, 1.90-25.20; p=0.003) were found to independently predict DVT in follow-up CT images within 1 month, proximal DVT at the initial presentation was found to independently predict DVT in follow-up CT images at 1 to 3 months (OR, 6.69; 95% CI, 1.53-29.23; p=0.012), and central PE was found to independently predict DVT in follow-up CT images at 3 to 9 months (OR, 4.25; 95% CI, 1.22-4.83; p=0.023) after the initial CT scan. Furthermore, the detection of DVT by follow-up CT independently predicted the recurrence of venous thromboembolism (VTE) (OR, 4.67; 95% CI, 2.24-9.74; p<0.001). Conclusion: Three months after PE, DVT was not detected by follow-up CT in most patients with PE. RV dilation on the initial CT, central PE, and proximal DVT at the initial presentation were found to predict DVT on follow-up CT, which might predict VTE recurrence.

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참고문헌

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