How I do it: CT pulmonary angiography

Area of Science:

• Radiology
• Medical Imaging

Background:

• Pulmonary embolism (PE) is a leading cause of cardiovascular death, frequently missed due to diagnostic challenges.
• Computed tomography pulmonary angiography (CTPA) has become a primary diagnostic tool for PE, revolutionizing patient care.

Purpose of the Study:

• To outline methods for optimizing CTPA image quality by addressing common artifacts.
• To describe diagnostic criteria for differentiating acute and chronic pulmonary emboli.
• To enhance the interpretation of indeterminate CTPA findings.

Main Methods:

• Review of techniques for artifact reduction: motion, vascular enhancement, flow, body habitus, noise, and streak artifacts.
• Illustration of diagnostic criteria for acute and chronic pulmonary embolism on CTPA.
• Discussion of strategies for improving vascular opacification in parenchymal lung disease.

Main Results:

• Specific techniques can significantly improve image quality in CTPA, reducing artifacts.
• Clear diagnostic criteria exist for identifying acute and chronic pulmonary emboli.
• Enhanced CTPA interpretation leads to earlier and more accurate diagnosis.

Conclusions:

• Pulmonary embolism remains a critical, often fatal, cardiovascular condition.
• CTPA is a vital noninvasive tool for diagnosing PE, with over 25 years of established efficacy.
• Continuous improvement in CTPA techniques and interpretation standards elevates the standard of care for patients with suspected PE.