Correlation between imaging characteristics of deep venous thrombosis at computed tomography venography and acute pulmonary embolism.

Background: Lower extremity deep venous thrombosis (LEDVT) is a common disease, which can lead to pulmonary embolism (PE), a potentially life-threatening complication. Computed tomography venography (CTV) has become an effective method to diagnose LEDVT. However, the correlation between CTV characteristics and the risk of PE remains inadequately understood. Therefore, the aim of this study was to explore the relationship between the imaging characteristics of LEDVT observed through CTV and the risk and involvement degree of PE. Methods: We retrospectively included 130 patients, with 70 in the LEDVT without PE group and 60 in the LEDVT with PE group. We compared the clinical features of patients and CTV characteristics of thrombus proximal end between the two groups, and then developed and validated a logistic regression model for predicting PE. Furthermore, we explored the correlation between the thrombus CTV characteristics and the involvement degree of PE. Results: LEDVT with PE was more prevalent in young and male patients (all P<0.05). Moreover, it was predominantly located in the right lower extremity, involved the femoral vein, and mainly exhibited non-pestle-shaped thrombus proximal end, filling sign, larger thrombus-to-vessel wall (T-V) gap maximum width and length, and higher density (all P<0.05). Multivariate analysis revealed that high thrombus density and a large T-V gap maximum width were independent predictors of PE. For this model, the area under the curve (AUC) of the training cohort was 0.874, whereas that of the external validation cohort was 0.858. Moreover, the involvement degree of PE was positively correlated with the T-V gap maximum width (r=0.618, P<0.001) and length (r=0.470, P<0.001). Conclusions: The CTV features of LEDVT were closely associated with the presence and involvement degree of concomitant PE.