Analysis of CT imaging features of acute pulmonary embolism complicated by pleural effusion

LI Haoyuan; ZHANG Hongxia; LIU Min

doi:10.20258/j.cnki.1006-9011.2025.05.011

Abstract：Objective To explore the CT pulmonary angiography(CTPA)manifestations of pleural effusion complicating acute pulmonary embolism(APE).Methods A total of 207 patients diagnosed with APE by CTPA were collected and divided into two groups based on the presence or absence of pleural effusion:the pleural effusion group and the non-pleural effusion group.The study compared the differences in CTPA imaging manifestations between the two groups.The pleural effusion group was further stratified into low-risk,medium-low-risk,and medium-high/high-risk categories based on the severity of the condi-tion,and the differences in CTPA imaging manifestations among these different risk stratifications were compared.A binary logis-tic regression analysis was used to examine the relationship between CTPA imaging characteristics of APE patients and the occur-rence of concurrent pleural effusion.Results Compared with the group without pleural effusion,the group with pleural effusion showed an increased proportion of accompanying mass shadows and pericardial effusion(P<0.05 or<0.01).The proportion of pa-tients with a small amount of pleural effusion in the medium-low-risk group was lower than that in the low-risk group and the medium-high/high-risk group,with no difference in the location of pleural effusion among the different risk stratification groups.Logistic regression analysis indicated that pericardial effusion was a risk factor for pleural effusion in patients with APE(OR=2.728,95%CI:1.200-6.199,P<0.05).Conclusions Patients with APE have a higher incidence of pleural effusion,which is often bilateral and minimal in volume.Pericardial effusion is a risk factor for the development of pleural effusion in APE patients.