Acute pulmonary embolism multimodality imaging prior to endovascular therapy

Int J Cardiovasc Imaging. 2021 Jan;37(1):343-358. doi: 10.1007/s10554-020-01980-9. Epub 2020 Aug 30.

Abstract

The manuscript discusses the application of CT pulmonary angiography, ventilation-perfusion scan, and magnetic resonance angiography to detect acute pulmonary embolism and to plan endovascular therapy. CT pulmonary angiography offers high accuracy, speed of acquisition, and widespread availability when applied to acute pulmonary embolism detection. This imaging modality also aids the planning of endovascular therapy by visualizing the number and distribution of emboli, determining ideal intra-procedural catheter position for treatment, and signs of right heart strain. Ventilation-perfusion scan and magnetic resonance angiography with and without contrast enhancement can also aid in the detection and pre-procedural planning of endovascular therapy in patients who are not candidates for CT pulmonary angiography.

Keywords: Acute pulmonary embolism; Computed tomography pulmonary angiography; Magnetic resonance angiography; Ventilation–perfusion scan.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Clinical Decision-Making
  • Computed Tomography Angiography*
  • Endovascular Procedures*
  • Humans
  • Magnetic Resonance Angiography*
  • Perfusion Imaging*
  • Predictive Value of Tests
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / physiopathology
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / physiopathology
  • Pulmonary Embolism / therapy*