A New Radiological Classification for Massive Pulmonary Embolism (SPECS)

Materials/Methods The study was conducted using the radiology database to identify all patients who had a CT pulmonary angiogram during the 12 months of 2014. A total of 1923 CTPAs were conducted, of which 210 were reported as large PE. These were examined, those with a segmental PE or poor quality imaging were excluded, leaving 154, 91 (59%) females in the study. The classification assessed location of clot (L) in major pulmonary arteries (scores 1, 2 and 4), the degree of occlusion (o) (score 1,2 and 3) and the impact on the right ventricle (RVR) (scores 1,2 and 3). Interventricular septum morphology (S) was also assessed (scores 1, 2, 3 and 4). Multipliers were used obtain the total score, [(L × O) × RVR] + S. Maximum score 64. This score was correlated with clinical outcome.