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.
Albrecht MH1,2, Bickford MW1, Nance JW Jr1, Zhang L3, De Cecco CN1, Wichmann JL2, Vogl TJ2, Schoepf UJ1,3.
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.