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Review
. 2022 Feb 14;8(1):529-539.
doi: 10.3390/tomography8010042.

Acute Pulmonary Embolism: Prognostic Role of Computed Tomography Pulmonary Angiography (CTPA)

Giulia Zantonelli  1 , Diletta Cozzi  1   2 , Alessandra Bindi  1 , Edoardo Cavigli  1 , Chiara Moroni  1 , Silvia Luvarà  1 , Giulia Grazzini  1 , Ginevra Danti  1 , Vincenza Granata  3 , Vittorio Miele  1
Affiliations
Review

Acute Pulmonary Embolism: Prognostic Role of Computed Tomography Pulmonary Angiography (CTPA)

Giulia Zantonelli et al. Tomography. .

Abstract

Computed Tomography Pulmonary Angiography (CTPA) is considered the gold standard diagnostic technique in patients with suspected acute pulmonary embolism in emergency departments. Several studies have been conducted on the predictive value of CTPA on the outcomes of pulmonary embolism (PE). The purpose of this article is to provide an updated review of the literature reporting imaging parameters and quantitative CT scores to predict the severity of PE.

Keywords: CTPA; emergency; pulmonary embolism; vascular.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient with fat-filling defects in the right upper lobar pulmonary artery in non-contrast (A) and contrast (B) axial scans. (C) CTPA illustration of RV/LV diameter ratio measurement; the measurement in this patient was 1.26. ((D), arrow) Reflux of contrast medium extended to hepatic veins (grade III).
Figure 2
Figure 2
Patient with embolism involving pulmonary arterial branches for the right upper and lower lobe (A) and a sub-segmental branch for the right upper lobe ((B), arrow). Pulmonary arterial trunk dilatation (35.4 mm) (C) and multiple pulmonary infarctions ((D), arrows) are shown.
Figure 3
Figure 3
Increase in the diameter of the veins and embolism. A middle-aged man with huge eccentric emboli attached to the vascular wall of both pulmonary arteries (A–C). (D) Dilatation of the coronary sinus (arrow); the measurement in this patient was 21 mm. Dilatation of the azygos vein (12.7 mm) (E).
Figure 4
Figure 4
(A,B) Axial and coronal (C) contrast-enhanced CT scans show saddle embolism and multiple eccentric emboli involving the lower lobar branches of the pulmonary arteries. (D) Left atrium, purple. There is decreased LA volume, 19 mL. (E) Axial scans in the lung window show peripheral ground-glass opacities in association with consolidation areas involving both lungs.
Figure 5
Figure 5
(A) The DECT iodine map allows for the detection of small pulmonary emboli in the left lower lobe. Simultaneous evaluation of the vascular and parenchymal distribution of iodine in the lungs with relief of a small embolus in the lingula (B) and the left lower lobe (C).
See this image and copyright information in PMC

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