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Relationship between the extent of deep venous thrombosis and the extent of acute pulmonary embolism as assessed by CT angiography

¹ Department of Medical Imaging, University Hospital of Liege, Liege, ² Department of Medical Imaging, Erasme Hospital, Université libre de Bruxelles and ³ Statistical Unit, Institute of Interdisciplinary Research in Human and Molecular Biology, Université libre de Bruxelles, Belgium

Correspondence: Benoit Ghaye, Department of Medical Imaging, University Hospital Sart Tilman – B35, B – 4000 Liege, Belgium. E-mail: bghaye{at}chu.ulg.ac.be

The aim of our study is to investigate prospectively the quantitative relationship between deep venous thrombosis (DVT) and acute pulmonary embolism (PE). 110 patients clinically suspected of having venous thromboembolic disease underwent combined CT pulmonary angiography (CTPA) and venography of lower limb veins. 44 patients presented with clinical signs of DVT and positive ultrasonography or ascending venography, but no clinical sign of PE (Group 1). 66 patients presented with clinical signs of PE and positive CTPA (Group 2). Clot load in lower limb veins and pulmonary arteries were scored by two independent readers, each using two separate systems for DVT and two for PE. 27 (61%) patients in Group 1 also had PE, and 55 (83%) patients in Group 2 also had DVT. Correlations between PE and DVT scores were weak but statistically significant in Group 2 (r_s ranging from 0.470–0.520; p0.001), but only some were significant in Group 1 (r_s ranging from 0.253–0.318; p-values ranging from 0.035–0.097). In conclusion, although PE occurs in a majority of patients with DVT, and vice versa, the amount/burden of clot load in one condition does not necessarily indicate — or indicates only weakly — the degree of burden in the other condition.