Imaging diagnosis of acute pulmonary embolism

Expert Review of Cardiovascular Therapy

Volumn 5, Issue 3, 2007, Pages 519-529

  Bozlar, Ugur ^a   Gaughen, John R ^b   Nambiar, Ashwin P ^a   Hagspiel, Klaus D ^a  

^a UNIVERSITY OF VIRGINIA HEALTH SYSTEM   (United States)

^b UNIVERSITY OF VIRGINIA   (United States)

Author keywords

Computed tomographic venography; Computed tomography; Fusion; Magnetic resonance angiography; Magnetic resonance direct thrombus imaging; Magnetic resonance imaging; Perfusion magnetic resonance; Pulmonary angiography; Pulmonary embolism; Ventilation perfusion

Indexed keywords

CONTRAST MEDIUM; RADIOACTIVE IODINE; RADIOISOTOPE;

ACUTE DISEASE; COMPUTER ASSISTED TOMOGRAPHY; CONTRAST ENHANCEMENT; DEEP VEIN THROMBOSIS; DIAGNOSTIC ACCURACY; DIAGNOSTIC IMAGING; DRUG SAFETY; FREQUENCY ANALYSIS; HEALTH CARE AVAILABILITY; HEALTH CARE UTILIZATION; HUMAN; LUNG ANGIOGRAPHY; LUNG EMBOLISM; LUNG SCINTISCANNING; MAGNETIC RESONANCE ANGIOGRAPHY; MULTIDETECTOR COMPUTED TOMOGRAPHY; NON INVASIVE PROCEDURE; NUCLEAR MEDICINE; PREGNANCY; PUBLIC HEALTH; RELIABILITY; REVIEW; RISK BENEFIT ANALYSIS; SENSITIVITY AND SPECIFICITY; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; THREE DIMENSIONAL IMAGING; THROMBOEMBOLISM; TRANSTHORACIC ECHOCARDIOGRAPHY; TREATMENT CONTRAINDICATION; TREATMENT INDICATION; VALIDATION PROCESS;

ACUTE DISEASE; ANGIOGRAPHY; IMAGE PROCESSING, COMPUTER-ASSISTED; MAGNETIC RESONANCE IMAGING; PULMONARY EMBOLISM;

EID: 34249308125     PISSN: 14779072     EISSN: 17448344     Source Type: Journal    
DOI: 10.1586/14779072.5.3.519     Document Type: Review

References (100)

1. Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog. Cardiovasc. Dis. 17(4), 259-270 (1975).
2. The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: result of the Prospective Investigation Of Pulmonary Embolism Diagnosis (PIOPED). JAMA 263(20), 2753-2759 (1990).
3. Carson JL, Kelley MA, Duff A et al. The clinical course of pulmonary embolism. N. Engl. J. Med. 326(19), 1240-1245 (1992).
4. Siddique RM, Siddique MI, Connors AF Jr, Rimm AA. Thirty day case fatality rates for pulmonary embolism in the elderly. Arch. Intern. Med. 156(20), 2343-2347 (1996).
5. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism: acontrolled trial. Lancet 1, 1309-1312 (1960).
6. Bell WR, Simon TL, de Mets DK. The clinical features of submassive and massive pulmonary emboli. Am. J. Med. 62(3), 355-360 (1977).
7. Szucs MM, Brooks HL, Gorssman W et al. Diagnostic sensitivity of laboratory findings in acute pulmonary embolism. Ann. Intern. Med. 74(2), 161-166 (1971).
8. Stein PD, Terrin ML, Hales CA et al. Clinical, laboratory, roentgenographic, and electrographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 100(3), 598-603 (1991).
9. Bounameaux H, de Moerloose P, Perrier A, Miron MJ. D-dimer testing in suspected venous thromboembolism: an update. QJM 90(7), 437-442 (1997).
10. Goldhaber SZ. Pulmonary embolism. N. Engl J. Med. 339(2), 93-104 (1998).
11. Scarsbrook AF, Evans AL, Owen AR, Gleeson FV. Diagnosis of suspected venous thromboembolic disease in pregnancy. Clin. Radiol. 61(1), 1-12 (2006).
12. Girard P, Musset D, Parent F et al. High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism. Chest 116(4), 903-908 (1999).
13. Kearon C, Julian JA, Newman TE et al. Noninvasive diagnosis of deep venous thrombosis. McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann. Intern. Med. 128(8), 663-677 (1998).
14. Fraser JD, Anderson DR. Deep venous thrombosis: recent advances and optimal investigation with US. Radiology 211(1), 9-24 (1999).
15. Quinn RJ, Nour R, Butler SP et al. Pulmonary embolism in patients with intermediate probability lung scans: diagnosis with Doppler venous US and D-dimer measurement. Radiology 190(2), 509-511 (1994).
16. Worsley DF, Alavi A. Comprehensive analysis of the results of the PIOPED study. J. Nucl. Med. 36(12), 2380-2387 (1995).
17. Stein PD, Fowler SE, Goodman LR et al. Multidetector computed tomography for acute pulmonary embolism. N. Engl. J. Med. 354(22), 2317-2327 (2006).
18. Collart JP, Roelants V, Vanpee D et al. Is a lung perfusion scan obtained by using single photon emission computed tomography able to improve the radionuclide diagnosis of pulmonary embolism? Nucl. Med. Commun. 23(11), 1107-1113 (2002).
19. Reinartz P, Wildberger JE, Schaefer W, Nowak B, Mahnken AH, Buell U. Tomographic imaging in the diagnosis of pulmonary embolism: a comparison between V/Q lung scintigraphy in SPECT technique and multislice spiral CT. J. Nucl. Med. 45(9), 1501-1508 (2004).
20. Winer-Muram HT, Rydberg J, Johnson MS et al. Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography. Radiology 233(3), 806-815 (2004).
21. Van Rossum AB, Pattynama PM, Ton ER et al. Pulmonary embolism: validation of spiral CT angiography in 149 patients. Radiology 201(2), 467-470 (1996).
22. Teigen CL, Maus TP, Sheedy PF et al. Pulmonary embolism: diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography. Radiology 194(2), 313-319 (1995).
23. Goodman LR, Curtin JJ, Mewissen MW et al. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT vs. angiography. Am. J. Roentgenol. 164(6), 1369-1374 (1995).
24. Garg K, Welsh CH, Feyerabend AJ et al. Pulmonary embolism: diagnosis with spiral CT and ventilation perfusion scanning-correlation with pulmonary angiographic results or clinical outcome. Radiology 208(1), 201-208 (1998).
25. Remy-Jardin M, Remy J, Wattinne L, Gitaud F. Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold technique - comparison with pulmonary angiography. Radiology 185(2), 381-387 (1992).
26. Remy-Jardin M, Remy J, Deschildre F et al. Diagnosis of pulmonary embolism with spiral CT: comparison with pulmonary angiography and scintigraphy. Radiology 200(3), 699-706 (1996).
27. Meaney JF, Weg JG, Chenevert TL, Stafford-Johnson D, Hamilton BH, Prince MR. Diagnosis of pulmonary embolism with magnetic resonance angiography. N. Engl. J. Med. 336(20), 1422-1427 (1997).
28. Patel S, Kazerooni EA, Cascade PN. Pulmonary embolism: optimization of small pulmonary artery visualization at multi-detector row CT. Radiology 227(2), 455-460 (2003).
29. Qanadli SD, Hajjam ME, Mesurolle B et al. Pulmonary embolism detection: prospective evaluation of dual-section helical CT versus selective pulmonary arteriography in 157 patients. Radiology 217(2), 447-455 (2000).
30. Coche E, Verschuren F, Keyeux A et al. Diagnosis of acute pulmonary embolism in outpatients: comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy. Radiology 229(3), 757-765 (2003).
31. Blachere H, Latrabe V, Montaudon M et al. Pulmonary embolism revealed on helical CT angiography: comparison with ventilation-perfusion radionuclide lung scanning. Am. J. Roentgenol. 174(4), 1041-1047 (2000).
32. Jones SE, Wittram C. The indeterminate CT pulmonary angiogram: imaging characteristics and patient clinical outcome. Radiology 237(1), 329-337 (2005).
33. Wittram C, Maher MM, Yoo AJ, Kalra MK, Shepard JA, McLoud TC. CT angiography of pulmonary embolism: diagnostic criteria and causes of misdiagnosis. Radiographics 24(5), 1219-1238 (2004).
34. Cham MD, Yankelevitz DF, Henschke CI. Thromboembolic disease detection at indirect CT venography versus CT pulmonary angiography. Radiology 234(2), 591-594 (2005).
35. Perrier A, Roy PM, Sanchez O et al. Multidetector-row computed tomography in suspected pulmonary embolism. N. Engl. J. Med. 352(17), 1760-1768 (2005).
36. van Belle A, Buller HR, Huisman MV et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 295(2), 172-179 (2006).
37. Berrington de Gonzalez A, Darby S. Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 363(9406), 345-351 (2004).
38. Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology 231(2), 393-398 (2004).
39. Cormack J, Towson JEC, Flower MA. Radiation protection and dosimetry in clinical practice. In: Nuclear Medicine in Clinical Diagnosis and Treatment. Ell PJ, Gambhir SS (Eds). Churchill Livingstone, London, UK 1871-1902 (2004).
40. Le Gal G, Righini M, Parent F, van Strijen M, Couturaud F. Diagnosis and management of subsegmental pulmonary embolism. J. Thromb. Haemost. 4(4), 724-731 (2006).
41. Eyer BA, Goodman LR, Washington L. Clinicians' response to radiologists' reports of isolated subsegmental pulmonary embolism or inconclusive interpretation of pulmonary embolism using MDCT. Am. J. Roentgenol. 184(2), 623-628 (2005).
42. Schultz DJ, Brasel KJ, Washington L et al. Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients. J. Trauma 56(4), 727-733 (2004).
43. Swensen SJ, Sheedy PF 2nd, Ryu JH et al. Outcomes after withholding anticoagulation from patients with suspected acute pulmonary embolism and negative computed tomographic findings: a cohort study. Mayo Clin. Proc. 77(2), 130-138 (2002).
44. Gottsater A, Berg A, Centergard J, Frennby B, Nirhov N, Nyman U. Clinically suspected pulmonary embolism: is it safe to withhold anticoagulation after a negative spiral CT? Eur. Radiol. 11(1), 65-72 (2001).
45. Goodman LR, Lipchik RJ, Kuzo RS, Liu Y, McAuliffe TL, O'Brien DJ. Subsequent pulmonary embolism: risk after a negative helical CT pulmonary angiogram - prospective comparison with scintigraphy. Radiology 215(2), 535-542 (2000).
46. van Belle A, Buller HR, Huisman MV et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 295(2), 172-179 (2006).
47. Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. Am. J. Roentgenol. 183(6), 1673-1689 (2004).
48. Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT. Hospital-acquired renal insufficiency: a prospective study. Am. J. Med. 74(2), 243-248 (1983).
49. McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am. J. Med. 103(5), 368-374 (1997).
50. Manske CL, Sprafka JM, Strony JT, Wang Y. Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography. Am. J. Med. 89(5), 615-620 (1990).
51. Rudnick MR, Goldfarb S, Wexler L et al. Nephrotoxicity of ionic and nonionic contrast media in 1,196 patients: a randomized trial - the Iohexol Cooperative Study. Kidney Int. 47(1), 254-261 (1995).
52. Tepel M, Aspelin P, Lameire N. Contrast-induced nephropathy: a clinical and evidence-based approach. Circulation 113(14), 1799-1806 (2006).
53. Davidson C, Stacul F, McCullough PA et al. CIN Consensus Working Panel. Overview. Am. J. Cardiol. 98, 2-4 (2006).
54. Davidson C, Stacul F, McCullough PA et al. CIN Consensus Working Panel. Contrast medium use. Am. J. Cardiol. 98(6A), 42K-58K (2006).
55. Aspelin P, Aubry P, Fransson SG et al. Nephrotoxic effects in high-risk patients undergoing angiography. N. Engl. J. Med. 348(6), 491-499 (2003).
56. Gaughen JR, Nandalur K, White B, Stewart R, Hagspiel KD. Reduced-dose iodinated contrast material administration yields diagnostic quality CTPA studies using 16-MDCT. Presented at: RSNA Scientific Assembly and Annual Meeting, Chicago, IL, USA 26 November - 1 December 2006.
57. Holmquist F, Nyman U. Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium. Eur. Radiol. 16(5), 1165-1176 (2006).
58. Nael K, Michaely HJ, Kramer U et al. Pulmonary circulation: contrast-enhanced 3.0-T MR angiography - initial results. Radiology 240(3), 858-868 (2006).
59. Kluge A, Mueller C, Strunk J, Lange U, Bachmann G. Experience in 207 combined MRI examinations for acute pulmonary embolism and deep vein thrombosis. Am. J. Roentgenol. 186(6), 1686-1696 (2006).
60. Pedersen MR, Fisher MT, van Beek EJ. MR imaging of the pulmonary vasculature - an update. Eur. Radiol. 16(6), 1374-1386 (2006).
61. Amundsen T, Torheim G, Waage A, Bjermer L, Steen PA, Haraldseth O. Perfusion magnetic resonance imaging of the lung: characterization of pneumonia and chronic obstructive pulmonary disease. A feasibility study. J. Magn. Reson. Imaging 12(2), 224-231 (2000).
62. Ohno Y, Hatabu H, Takenaka D, Adachi S, Kono M, Sugimura K. Solitary pulmonary nodules: potential role of dynamic MR imaging in management - initial experience. Radiology 224(2), 503-511 (2002).
63. Fink C, Bock M, Puderbach M, Schmahl A, Delorme S. Partially parallel three-dimensional magnetic resonance imaging for the assessment of lung perfusion - initial results. Invest. Radiol. 38(8), 482-488 (2003).
64. Ohno Y, Kawamitsu H, Higashino T et al. Time-resolved contrast-enhanced pulmonary MR angiography using sensitivity encoding (SENSE). J. Magn. Reson. Imaging 17(3), 330-336 (2003).
65. Kluge A, Gerriets T, Lange U, Bachman G. MRI for short-term follow-up of acute pulmonary embolism. Assessment of thrombus appearance and pulmonary perfusion: a feasibility study. Eur. Radiol. 15(9), 1969-1977 (2005).
66. Fratz S, Hess J, Schwaiger M, Martinoff S, Stern HC. More accurate quantification of pulmonary blood flow by magnetic resonance imaging than by lung perfusion scintigraphy in patients with fontan circulation. Circulation 106(12), 1510-1513 (2002).
67. Levin DL, Chen Q, Zhang M, Edelman RR, Hatabu H. Evaluation of regional pulmonary perfusion using ultrafast magnetic resonance imaging. Magn. Reson. Med. 46(1), 166-171 (2001).
68. Fink C, Puderbach M, Ley S, Zaporozhan J, Plathow C, Kauczor HU. Time-resolved echo-shared parallel MRA of the lung: observer preference study of iage quality in comparison with non-echo-shared sequences. Eur. Radiol. 15(10), 2070-2074 (2005).
69. Moody AR. Magnetic resonance direct thrombus imaging. J. Thromb. Haemost. 1(7), 1403-1409 (2003).
70. Kelly J, Hunt BJ, Moody A. Magnetic resonance direct thrombus imaging: a novel technique for imaging venous thromboemboli. Thromb. Haemost. 89(5), 773-782 (2003).
71. Fraser DG, Moody AR, Morgan PS, Martel AL, Davidson I. Diagnosis of lower-limb deep venous thrombosis: a prospective blinded study of magnetic resonance direct thrombus imaging. Ann. Intern. Med. 136(2), 89-98 (2002).
72. Moody AR, Liddicoat A, Krarup K. Magnetic resonance pulmonary angiography and direct imaging of embolus for the detection of pulmonary emboli. Invest. Radiol. 32(8), 431-440 (1997).
73. Moody AR. Crossley I, Moorby S, Delay G. Magnetic resonance direct thrombus imaging (MR DTI) as a first line investigation for pulmonary embolism - the PDR trial. Proceedings of the 11th Annual Scientific Meeting of the ISMRM, Toronto, Canada 10-16 July 2003.
74. Dalen JE, Brooks HL, Johnson LW, Meister SG, Szucs MM Jr, Dexter L. Pulmonary angiography in acute pulmonary embolism: indications, techniques and results in 367 patients. Am. Heart J. 81(2), 175-185 (1971).
75. Stein PD, Athanasoulis C, Alavi A et al. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation 85(2), 462-468 (1992).
76. Hudson ER, Smith TP, McDermott VG et al. Pulmonary angiography performed with iopamidol: complications in 1,434 patients. Radiology 198(1), 61-65 (1996).
77. Perlmutt LM, Braun SD, Newman GE et al. Pulmonary arteriography in the high-risk patient. Radiology 162(1 Pt 1), 187-189 (1987).
78. Hagspiel KD, Polak JF, Grassi CJ, Faitelson BB, Kandarpa K, Meyerovitz MF. Pulmonary embolism comparison of cut-film and digital pulmonary angiography. Radiology 207(1), 139-145 (1998).
79. van Beek EJ, Bakker AD, Reekers JA. Pulmonary embolism: interobserver agreement in the interpretation of conventional angiographic and DSA images in patients with nondiagnostic lung scan results. Radiology 198(3), 721-724 (1996).
80. Baile EM, King GG, Muller NL et al. Spiral computed tomography is comparable to angiography for the diagnosis of pulmonary embolism. Am. J. Respir. Crit. Care Med. 161(3 Pt 1), 1010-1005 (2000).
81. Wittram C, Waltman AC, Shepard JO, Halpern E, Goodman LR. Analysis of the CT - angiographic discordant reads from the PIOPED II study. Presented at: RSNA Scientific Assembly and Annual Meeting. Chicago, IL, USA 26 November - 1 December 2006.
82. Vigo M, Pesavento R, Bova C et al. The value of four-detector row spiral computed tomography for the diagnosis of pulmonary embolism. Semin. Thromb. Hemost. 32(8), 831-837 (2006).
83. Jardin F, Dubourg O, Bourdarias JP. Echocardiographic pattern of acute cor pulmonale. Chest 111(1), 209-217 (1997).
84. Line BR, Keenan JF, Lukasiewicz RL et al. Cardiopulmonary thromboembolism detected by Tc-99m MH-1 antifibrin antibody. Clin. Nucl. Med. 22(6), 376-379 (1997).
85. Altes TA, Mai VM, Munger TM, Brookeman JR, Hagspiel KD. Pulmonary embolism: comprehensive evaluation with MR ventilation and perfusion scanning with hyperpolarized helium-3, arterial spin tagging, and contrast-enhanced MRA. J. Vasc. Interv. Radiol. 16(7), 999-1005 (2005).
86. Kluge A, Luboldt W, Bachmann G. Acute pulmonary embolism to the subsegmental level: diagnostic accuracy of three MRI techniques compared with 16-MDCT. Am. J. Roentgenol. 187(1), W7-W14 (2006).
87. Kluge A, Gerriets T, Stolz E et al. Pulmonary perfusion in acute pulmonary embolism: agreement of MRI and SPECT for lobar, segmental and subsegmental perfusion defects. Acta Radiol. 47(9), 933-940 (2006).
88. Yilmaz E, Akkoclu A, Degirmenci B et al. Accuracy and feasibility of dynamic contrast-enhanced 3D MR imaging in the assessment of lung perfusion: comparison with Tc-99 MAA perfusion scintigraphy. Clin. Radiol. 60(8), 905-913 (2005).
89. Suga K, Kawakami Y, Iwanaga H, Hayashi N, Seto A, Matsunaga N. Comprehensive assessment of lung CT attenuation alteration at perfusion defects of acute pulmonary thromboembolism with breath-hold SPECT-CT fusion images. J. Comput. Assist. Tomogr. 30(1), 83-91 (2006).
90. Harris B, Bailey D, Roach P, Bailey E, King G. Fusion imaging of computed tomographic pulmonary angiography and SPECT ventilation/ perfusion scintigraphy: initial experience and potential benefit. Eur. J. Nucl. Med. Mol. Imaging 34(1), 135-142 (2007).
91. Groves AM, Yates SJ, Win T et al. CT pulmonary angiography versus ventilation-perfusion scintigraphy in pregnancy: implications from a UK survey of doctors' knowledge of radiation exposure. Radiology 240(3), 765-770 (2006).
92. Winer-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT. Pulmonary embolism in pregnant patients: fetal radiation dose with helical CT. Radiology 224(2), 487-492 (2002).
93. Administration of Radioactive Substances Advisory Committee. Notes for guidance on clinical administration of radiopharmaceuticals and use of sealed sources. National Radiological Protection Board 36, Chilton, UK (1998).
94. Kuiper JW, Geleijns J, Matheijssen NA, Teeuwisse W, Pattynama PM. Radiation exposure of multi-row detector spiral computed tomography of the pulmonary arteries: comparison with digital subtraction pulmonary angiography. Eur. Radiol. 13(7), 1496-1500 (2003).
95. Russell JR, Stabin MG, Sparks RB, Watson E. Radiation absorbed dose to the embryo/fetus from radiopharmaceuticals. Health Phys. 73(5), 756-769 (1997).
96. Hall JL, Navarrete JL, Surprenant E, Sklansky J, Eisenman JI. Technical note: a new TLD-phantom measurement system for determining dose distribution levels in the right and left breast from spiral CT chest imaging. J. Appl. Clin. Med. Phys. 3(4), 324-327 (2002).
97. Morisetti A, Tirone P, Luzzani F, de Haen C. Toxicological safety assessment of iomeprol, a new x-ray contrast agent. Eur. J. Radiol. 18(Suppl. 1), S21-S31 (1994).
98. Althen JN. Automatic tube-current modulation in CT - a comparison between different solutions. Radiat. Prot. Dosimetry 114(1-3), 308-312 (2005).
99. Matthews S. Short communication: imaging pulmonary embolism in pregnancy: what is the most appropriate imaging protocol? Br. J. Radiol. 79(941), 441-444 (2006).
100. Nijkeuter M, Huisman W. Diagnosing pulmonary embolism in pregnancy: is there a role for D-dimer as a stand-alone test? Crit. Care Med. 34(10), 2701 (2006).