الفهرس 
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Abstract
In this prospective study, we sought to determine the predictive value of quantified CT pulmonary angiographic clot burden on the clinical outcome of patients with PE, and its correlation with other PE severity predictors .The study was performed on 100 patients with proven pulmonary embolism and for all patients the following was done:
-Full detailed history
-Thorough clinical examination.
-Electrocardiogram
-Echocardiography
-Bilateral lower limbs venous duplex:
-D-dimer measurement
.-Cardiac troponin
-Arterial blood gases sample analysis
-MDCTPA using 64 multi–detectors row CT scanner
-For each patient, the information collected included patient out come—survival or death and cause of death either due to PE or related to other causes and whether the patient received Anticoagulation and/or Thrombolytic therapy or not.
We found that the PE index is a significant predictor of patient mortality. There is a visually appreciable cutoff at the PE index of 50% that separates survival and death. All deaths in the 50% and higher category were related to the presence of PE.
The PE index remains a significant predictor of patient death after adjusting for patient age, sex, findings of cardiac echo and ECG, and presence of cancer or other causes.
Also, we found that the PE index is highly correlated with presence of RVD, biomarkers of myocardial injury which was troponin in our study
We observed that percentage of number of patients with troponin positive differed significantly between above and below the 50% (p < 0.001), and PEI higher than 50% values.
The percentage of patients with RVD at each cutoff differed significantly between above and below the PEI cutoff value of 30% (p < 0.001), and PEI higher than 30% values.
Furthermore, correlations between the pulmonary artery obstruction index and arterial blood gases values were found to be statistically significant.
There was no statistically significant correlation between the D-dimer values, ECG score or presence of DVT and PEI values.
Furthermore, 99 patients in the study population received anticoagulation therapy. Seven patients received thrombolytic therapy with PEI 40%and higher category
(5 patients survived and 2 patients died due to PE with PEI 89.4% and 92.1%).These findings, would allow the stratification of a patient‘s risk of
death and might help identify patients who would benefit from more aggressive treatment strategies, such as thrombolysis.
Our study results strongly suggest that MDCT PE index appears reproducible and highly useful for stratification of patient risk and determining therapeutic options.
This may form the basis of a larger scale prospective clinical study, and potentially could be valuable as a triage to trigger the early application of aggressive treatments like embolectomy or catheter-directed thrombolysis and clot disruption.