Devaraj Anand, Sayer Charlie, Sheard Sarah, Grubnic Sisa, Nair Arjun, Vlahos Ioannis
*Department of Radiology, Royal Brompton Hospital †Department of Radiology, St George's Hospital ‡Department of Radiology, Guy's and St Thomas' Hospitals, London, UK.
J Thorac Imaging. 2015 May;30(3):176-92. doi: 10.1097/RTI.0000000000000146.
Acute pulmonary embolism is recognized as a difficult diagnosis to make. It is potentially fatal if undiagnosed, yet increasing referral rates for imaging and falling diagnostic yields are topics which have attracted much attention. For patients in the emergency department with suspected pulmonary embolism, computed tomography pulmonary angiography (CTPA) is the test of choice for most physicians, and hence radiology has a key role to play in the patient pathway. This review will outline key aspects of the recent literature regarding the following issues: patient selection for imaging, the optimization of CTPA image quality and dose, preferred pathways for pregnant patients and other subgroups, and the role of CTPA beyond diagnosis. The role of newer techniques such as dual-energy CT and single-photon emission-CT will also be discussed.
急性肺栓塞被认为是一种难以诊断的疾病。如果未被诊断出来，它可能会致命，然而，影像学检查转诊率的上升和诊断率的下降是备受关注的话题。对于急诊科疑似肺栓塞的患者，计算机断层扫描肺动脉造影（CTPA）是大多数医生的首选检查方法，因此放射学在患者诊疗流程中起着关键作用。本综述将概述近期文献中关于以下问题的关键要点：影像学检查的患者选择、CTPA图像质量和剂量的优化、孕妇及其他亚组患者的首选诊疗流程，以及CTPA在诊断之外的作用。还将讨论双能CT和单光子发射CT等新技术的作用。
