Role of Multislice Computed Tomography of the Thorax for the Evaluation of Suspected Pulmonary Embolism

Abstract

Multidetector computed tomography (MDCT), with its ability to rapidly acquire very thin sections, has become the cornerstone of imaging of pulmonary embolism (PE). Its availability, speed, and high negative predictive value (95-99%) make it an ideal modality for the evaluation of PE. MDCT also allows the concurrent evaluation of a wide variety of other thoracic disorders, including pulmonary parenchymal diseases, aortic dissection, and coronary artery disease. This article discusses attempts to validate computed tomography (CT) as the primary imaging modality for PE using both comparison with angiography as the gold standard and outcomesbased methods. Additionally, the advantages of MDCT over singledetector scanners, CT findings of acute and chronic PE, common CT artifacts, radiation, and CT-PE in pregnancy are discussed.

Venous thromboembolism during pregnancy, postpartum or during contraceptive use

“…Certainly, ventilation-perfusion lung scan is less accurate, particularly in patients with abnormal chest X-ray, but in the setting of young women with a normal chest radiograph and no history of cardiopulmonary disease, ventilation-perfusion scan should probably be considered the test of choice. Alternatively, the use of thin-layered bismuth garments to reduce the radiation dose would also be helpful (19).…”