State-of-the-Art Pulmonary CT Angiography for Acute Pulmonary Embolism

AJR Am J Roentgenol. 2017 Mar;208(3):495-504. doi: 10.2214/AJR.16.17202. Epub 2016 Nov 29.

Abstract

Objective: Pulmonary CT angiography (CTA) is the imaging modality of choice in suspected acute pulmonary embolism (PE). Current pulmonary CTA techniques involve ever lower doses of contrast medium and radiation along with advanced postprocessing applications to enhance image quality, diagnostic accuracy, and provide added value in patient management. The objective of this article is to summarize these current developments and discuss the appropriate use of state-of-the-art pulmonary CTA.

Conclusion: Pulmonary CTA is well established as a fast and reliable means of excluding or diagnosing PE. Continued developments in CT system hardware and postprocessing techniques will allow incremental reductions in radiation and contrast material requirements while improving image quality. Advances in risk stratification and prognostication from pulmonary CTA examinations should further refine its clinical value while minimizing the potential harm from overutilization and overdiagnosis.

Keywords: acute pulmonary embolism; pulmonary CT angiography (CTA).

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Algorithms*
  • Computed Tomography Angiography / methods*
  • Contrast Media
  • Evidence-Based Medicine
  • Humans
  • Pattern Recognition, Automated / methods
  • Pulmonary Embolism / diagnostic imaging*
  • Radiation Exposure / prevention & control*
  • Radiation Protection / methods
  • Radiographic Image Enhancement / methods*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media