CT pulmonary angiography


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CT pulmonary angiography

The best contemporary test to assess a patient suspected of having a pulmonary embolism The test uses computed tomographic imaging of the pulmonary arteries to identify blood clots in the right ventricular outflow tracts or the pulmonary arteries. The presence of a clot indicates the need for treatment with anticoagulant drugs. It is used as the generally preferred alternative to invasive pulmonary angiography (which, while accurate, requires right ventricular catheterization), or to ventilation/perfusion scanning of the lungs (which often yields indeterminate results).

CAUTION!

Potential hazards of the test include its radiation exposure, its risk for renal failure (esp. in patients with predisposing conditions for kidney injury), and the risk of allergy to the radiological contrast agent used in the test.
See also: angiography
References in periodicals archive ?
Iterative reconstruction in single source dual-energy CT pulmonary angiography: is it sufficient to achieve a radiation dose as low as the state-of-the-art single energy CTPA?
Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CT pulmonary angiography. Eur J Radiol 2014: 83:322-328.
In two studies of 25 patients with PE and 14 patients with massive PE, Contractor et al and Lim et al found that signs of RV strain at CT pulmonary angiography (RV/LV diameter ratiogreater than 1, leftward septal bowing) had a sensitivity of 78%-92%, specificity of 100%, and positive predictive value of 100% when compared to echocardiographic findings for the detection of RV dysfunction similarly other studies have estimated that an RV/LV diameter ratio superior to 1.5 indicates severe PE 11,12,13,16 .
Multidetector row CT pulmonary angiography and indirect venography for the diagnosis of venous thromboembolic disease in intensive care unit patients.
A dose of at least 2.0 rads per breast is typically delivered during CT pulmonary angiography. This is equivalent to 100-400 chest radiographs or 10-25 two-view mammograms.
CT pulmonary angiography is the noninvasive imaging examination of choice for suspected PE in most situations.
Does addition of CT pelvic venography to CT pulmonary angiography protocols contribute to the diagnosis of pulmonary thromboembolic disease?
High pitch, low voltage dual source CT pulmonary angiography: assessment of image quality and diagnostic acceptability with hybrid iterative reconstruction.
"We need a better test," and CT pulmonary angiography is emerging as the front runner.
Combining CTV with CT pulmonary angiography (CTPA) not only increases the confidence in withholding treatment when results for both the pulmonary arteries and leg veins are negative but also increases the diagnosis of venous thromboembolism by 25% over CTPA alone.
Studies that compared single-detector spiral CT pulmonary angiography with V/Q scanning showed that CT was a more accurate examination with higher specificity, particularly in those patients with underlying cardiopulmonary disease in whom the vast majority (90% in the PIOPED 1 study) have indeterminate V/Q scan results.
CT pulmonary angiography for the detection of pulmonary embolism: Interobserver agreement between on-call radiology residents and specialists (CTPA interobserver agreement).