Imaging Pulmonary Embolic Disease

Abstract

The purpose of this article is to review the imaging findings and current imaging techniques of acute pulmonary embolism (PE) and chronic thromboembolic disease. Special considerations are also discussed, including pregnancy, congenital heart disease, lower extremity computed tomography (CT), and the isolated subsegmental PE. CT pulmonary angiography and planar ventilation/perfusion (V/Q) lung scintigraphy are the primary means of evaluating pulmonary embolic disease. Magnetic resonance angiography avoids ionizing radiation and iodinated contrast in select patients. V/Q SPECT/CT provides greater accuracy and fewer non-diagnostic exams than planar V/Q scans. Dual-energy CT may prove valuable in the diagnosis of and preoperative planning for chronic thromboembolic pulmonary hypertension. Imaging plays a central role in identifying thromboembolic disease, but understanding the benefits and limitations when choosing the appropriate modality is imperative. Further research is needed to elucidate the role of emerging technologies in the assessment of thromboembolic disease.