[Value of multislice CT for the work-up of pulmonary embolism]

Abstract

Multislice computed tomography (MSCT) of the pulmonary arteries has overcome the limitations of single-slice CT and is accepted as the sole reference standard for imaging pulmonary embolism (PE) in many institutions. This technique provides the opportunity of efficient risk stratification to enable adequate differential therapy. With a low or intermediate pretest probability and a negative CT angiography (CTA), relevant PE can be ruled out safely. In >30% further diagnoses other than pulmonary embolism, e.g., pneumonia or aortic aneurysm, can be established on the basis of thoracic CTA. This article discusses the present role of MSCT in diagnostic imaging of PE and provides optimized acquisition protocols as well as practical aspects for secondary image reconstruction. Examples of typical imaging features of PE are shown. Diagnostic algorithms for daily emergency practice are discussed with respect to artifacts and pitfalls in image interpretation.