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      Pulmonary embolism and computed tomography angiography: Characteristic findings and technical advices

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          Abstract

          Pulmonary embolism (PE) is a condition due to blood clots obstructing pulmonary arteries, often related to deep venous thrombosis (DVT). PE can be responsible for acute and even life-threatening clinical situations and it may also lead to chronic sequelae such as chronic thromboembolic pulmonary hypertension (CTEPH). Signs and symptoms associated to PE may overlap those of many other diseases (e.g. chest pain, dyspnea, etc.), therefore an accurate clinical evaluation is mandatory before referring the patient to the most appropriate imaging technique. Pulmonary angiography (PA) has been traditionally considered the gold standard regarding the diagnosis of PE and it is also useful regarding the treatment of said condition. However, PA is an invasive technique, implying all the known risks concerning endovascular procedures. Nowadays, computed tomography angiography (CTA) is considered the imaging technique of choice regarding the diagnosis of PE. This technique is readily-available in most centers and it is able to provide high resolution images, although it implies the administration of ionizing radiations and iodinated contrast medium. Conventional CTA has further been improved with the use of ECG-gated protocols, aimed to reduce motion artifacts due to heartbeat and to evaluate other causes of sudden onset chest pain. Moreover, another interesting technique is dual energy computed tomography (DECT), which allows to elaborate iodine maps, allowing to detect areas of hypoperfusion due to the presence of emboli in pulmonary arteries. This review is aimed to describe the main findings related to PE with an emphasis on CTA, also discussing technical aspects concerning image acquisition protocol.

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          Author and article information

          Contributors
          Journal
          1647
          Imaging
          Imaging
          Akadémiai Kiadó (Budapest )
          2732-0960
          26 November 2021
          Affiliations
          [1 ] Department of Radiology, University Hospital Sant’Andrea, University of Rome “La Sapienza” , Rome, Italy
          [2 ] Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, University Milano Bicocca , Milan, Italy
          Author notes
          [* ]Corresponding author. Radiology Department, University Hospital Sant’Andrea, University of Rome “La Sapienza”, Via di Grottarossa, 1035/1039 , 00189, Rome, Italy. Tel.: +39 3291378494. E-mail: e.muscogiuri@ 123456gmail.com
          Article
          10.1556/1647.2021.00050
          e343dffe-b6a8-4966-acf7-3468de691ffe
          © 2021 The Author(s)

          Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

          Page count
          Figures: 7, Tables: 1, Equations: 0, References: 42, Pages: 10

          Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
          computed tomography angiography,image acquisition protocol,dual energy computed tomography,pulmonary embolism,ECG-gated computed tomography

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