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Original Research

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A pulmonary embolism (PE) that obstructs pulmonary arterial blood flow is a medical emergency. Its early detection and appropriate management can be lifesaving. CT pulmonary angiography (CTPA) is currently in use as a standard tool for diagnosis of PE. This study was performed to determine the prognostic accuracy of contrast reflux into the inferior vena cava (IVC) and hepatic veins on CTPA in patients suffering from acute PE.

Materials and Methods

The study was composed of 285 patients between 15 to 85 years of age that had filling defects in pulmonary arteries on CTPA that were consistent with those of a pulmonary embolism. The extent of contrast reflux into the IVC and hepatic veins was determined on the basis of a Groves scale. The patients were followed for a period of 30 days.


Of 285 total patients, 200 (70.17%) survived the post PE period of 30 days and were labeled as survivors. The other 85 (29.83%) patients did not survive the 30-day duration and were called non-survivors. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of IVC contrast reflux grading were 65.8%, 90%, 73.68%, 86.12 % and 82.8 % respectively.


We conclude that IVC contrast reflux grading assessed on helical CT is a beneficial tool for predicting prognosis in cases of acute PE.


pulmonary embolism, contrast reflux, inferior vena cava, prognosis

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© 2022 Raza, Arif, Raza, Yasin, Asghar and Ziad. This open access article is distributed under a Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/).

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.


We would like to thank Dr. Atif Rana (Interventional Radiologist and Chairperson of Radiology Department at SIH) and Dr. Belqees Yawar Faiz (consultant Radiologist at SIH) for their continual encouragement and support of our research. We would also like to acknowledge the efforts and guidance of Dr. Sadia Babar (consultant Radiologist at SIH) for her early appreciation for this idea and valuable feedback.

Corresponding Author(s)

Farheen Raza, Radiology Department, Shifa International Hospital, Islamabad, Pakistan; farhinraza@gmail.com

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