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Rofo. 2019 May 28. doi: 10.1055/a-0900-4200. [Epub ahead of print]

Acute Pulmonary Embolism: Imaging Techniques, Findings, Endovascular Treatment and Differential Diagnoses.

Author information

1
Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
2
Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.
3
Department of Radiology, Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, United States.
4
Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany.
5
Interventional Radiology Section, Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States.

Abstract

in English, German

BACKGROUND:

 Acute thrombotic pulmonary embolism (PE) is a common and potentially fatal event with imaging playing a pivotal role in the diagnosis and management of these patients.

METHOD:

 This review discusses imaging techniques, diagnostic algorithms, imaging findings and endovascular treatment of acute thrombotic PE, and illustrates important differential diagnoses relating to the spectrum of acute non-thrombotic PE and non-embolic pulmonary artery disease. The review emphasizes information relevant for everyday radiological practice and highlights recent advances that can be readily applied in the clinical routine.

RESULTS/CONCLUSION:

 Computed tomography pulmonary angiography (CTPA) is the current reference standard for the diagnosis of acute PE. Ventilation and perfusion (VQ) scanning or - in centers with adequate expertise - magnetic resonance imaging (MRI) is indicated in pregnant or young patients and patients with contraindications to iodinated contrast. Invasive angiography is reserved for patients with intended endovascular treatment. Artifacts, acute non-thrombotic PE, chronic PE and non-embolic pulmonary artery diseases should always be considered as differential diagnoses.

KEY POINTS:

  · CTPA is the reference standard for the diagnosis of acute PE.. · MRI for acute PE should only be performed in centers with adequate expertise.. · Invasive angiography is reserved for patients with intended endovascular treatment.. · Artifacts and non-embolic pulmonary artery diseases can mimic acute pulmonary thromboembolism.. · Non-thrombotic and chronic PE are also differential diagnoses of acute pulmonary thromboembolism..

CITATION FORMAT:

· Palm V, Rengier F, Rajiah P et al. Acute Pulmonary Embolism: Imaging Techniques, Findings, Endovascular Treatment and Differential Diagnoses. Fortschr Röntgenstr 2019; DOI: 10.1055/a-0900-4200.

PMID:
31137046
DOI:
10.1055/a-0900-4200
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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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