[Role of spiral CT in the emergency diagnosis of pulmonary embolism]

The pulmonary arteries can be visualized with spiral CT after injection of iodinated contrast material. Its contribution to emergency diagnosis of pulmonary embolism has been recently evaluated. Sensitivity for the detection of segmentary or more proximal thrombi is nearly 100% with a specificity estimated at 96%. These figure are much lower for subsegmentary emboli, varying from 63% to 83% for sensitivity and from 85% to 100% for specificity. The requirement for treatment in these minor forms remains however a topic of debate. Due to its noninvasive character and the diagnostic performance, spiral CT is well adapted for cases of suspected massive embolism. Inversely, for minimal embolism, spiral CT cannot eliminate the diagnosis before the results of other explorations are known.