Pulmonary angiography and the diagnosis of pulmonary embolism

Pulmonary angiography is the definitive study for the identification of embolism. The development of accurate noninvasive methods for the detection of deep venous thrombosis has altered the indications for angiography. Many angiographic techniques have been developed, providing the opportunity to tailor the angiogram to the clinical situation of individual patients. Strict criteria must be used for interpretation of angiographic studies, and using state of the art equipment will diminish technically unsatisfactory examinations. CT and MR angiography will assume a significantly larger role in the identification of PE in the very near future. MR may become the method of choice, because it is the one noninvasive technique that shows promise for the study of both the deep venous system of the legs and pelvis and the pulmonary circulation.