Imaging of pulmonary embolism
"If a diagnosis of pulmonary embolism (PE) has not been excluded after the initial clinical assessment and chest X-ray, the options for further evaluation include V/Q scintigraphy and CT. CT pulmonary angiography allows the pulmonary arterial system to be visualised and inter-observer agreement is generally very good for a diagnosis of PE. The advantage of CT over other imaging techniques is that it also demonstrates other aspects of the thoracic anatomy and facilitates alternative diagnoses. This is important since up to two-thirds of patients with suspected PE may eventually receive a different diagnosis. The advent of spiral MDCT provides a powerful tool for diagnosis of PE that is currently being compared with various combinations of tests in the PIOPED II study. CT is undoubtedly very valuable for the diagnosis of PE, but in order to reduce radiation exposure, it should be the last step in a sequential clinical evaluation."
From article by Simon PG Padley, Kapila Jain. Imaging of pulmonary embolism. in Controversies and Consensus in Imaging and Intervention.
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