Imaging of acute pulmonary embolism: an update

Alastair J. E. Moore, Jason Wachsmann, Murthy R. Chamarthy, Lloyd Panjikaran, Yuki Tanabe, Prabhakar Rajiah


Imaging plays an important role in the evaluation and management of acute pulmonary embolism (PE). Computed tomography (CT) pulmonary angiography (CTPA) is the current standard of care and provides accurate diagnosis with rapid turnaround time. CT also provides information on other potential causes of acute chest pain. With dual-energy CT, lung perfusion abnormalities can also be detected and quanti ed. Chest radiograph has limited utility, occasionally showing ndings of PE or infarction, but is useful in evaluating other potential causes of chest pain. Ventilation-perfusion (VQ) scan demonstrates ventilation-perfusion mismatches in these patients, with several classi cation schemes, typically ranging from normal to high. Magnetic resonance imaging (MRI) also provides accurate diagnosis, but is available in only specialized centers and requires higher levels of expertise. Catheter pulmonary angiography is no longer used for diagnosis and is used only for interventional management. Echocardiography is used for risk strati cation of these patients. In this article, we review the role of imaging in the evaluation of acute PE.