Multislice CT virtual intravascular endoscopy for assessing pulmonary embolisms: a pictorial review

Multislice CT has been widely used in clinical practice for diagnosing cardiovascular disease due to its reduced invasiveness and its high spatial and temporal resolution. As a reliable alternative to conventional pulmonary angiography, multislice CT angiography has been recognized as the first line technique for detecting and diagnosing pulmonary embolism. A pulmonary embolism located in the main pulmonary artery, as well as being located in the segmental branches, can be accurately detected with multislice CT imaging, and especially with the use of 16- and 64-slice CT scanners. Visualization of pulmonary embolisms has traditionally been limited to 2D, multiplanar reformation and the 3D external surface visualizations. In this pictorial review, we present our experience of using 3D virtual intravascular endoscopy to characterize and evaluate the intraluminal appearance of pulmonary embolisms in a group of patients who were suspected of having pulmonary embolism and who were undergoing multislice CT angiography. We expect that the research findings from this study will provide insight into the extent of disease and the luminal changes to the pulmonary arteries that are due to the presence of thrombus, and so monitoring of the progress of disease and predicting the treatment outcome can well be achieved.