[Diagnostic and interventional radiology in pulmonary embolism]

Area of Science:

• Radiology
• Cardiovascular Imaging
• Diagnostic Medicine

Background:

• Pulmonary embolism (PE) presents with nonspecific clinical signs, necessitating imaging for diagnosis.
• PE is a complication of deep venous thrombosis (DVT), indicating a strong correlation between the two conditions.

Purpose of the Study:

• To review and compare various radiologic screening methods for diagnosing pulmonary embolism and deep venous thrombosis.
• To evaluate the diagnostic value and limitations of different imaging modalities in the context of PE and DVT.

Main Methods:

• Review of noninvasive and invasive radiologic tests for PE and DVT.
• Discussion of Chest X-ray, CT scanning, MRI, digital subtraction angiography, and conventional pulmonary angiography.
• Evaluation of venous studies including contrast phlebography and venous ultrasound imaging with compression Doppler.

Main Results:

• Chest X-ray has limited predictive value for PE.
• CT scanning can detect central emboli; MRI has limited clinical value.
• Conventional pulmonary angiography is definitive but often preceded by venous studies.
• Venous ultrasound with Doppler is safe and accurate for lower extremity veins; contrast phlebography is a standard, widely available method.

Conclusions:

• Accurate diagnosis of PE and DVT relies on a combination of imaging techniques.
• Venous studies, particularly ultrasound and contrast phlebography, play a crucial role in identifying the source of PE.
• While conventional angiography remains definitive, less invasive methods are increasingly valuable.