Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Radiology, The University of Texas Medical Branch, UTMB. Galveston TX.
Semin Ultrasound CT MR. 2022 Jun;43(3):221-229. doi: 10.1053/j.sult.2022.01.004. Epub 2022 Feb 5.
Pulmonary embolism (PE) can present with a wide spectrum of clinical symptoms that can overlap considerably with other cardiovascular diseases. To avoid PE related morbidity and mortality, it is vital to identify this disease accurately and in a timely fashion. Several clinical criteria have been developed to standardize the diagnostic approach for patients with suspected PE. Computed tomographic pulmonary angiogram has significantly improved the detection of pulmonary embolism and is considered the imaging modality of choice to diagnose this disease. However, there are several potential pitfalls associated with this modality which can make diagnosis of PE challenging. In this review, we will discuss various pitfalls routinely encountered in the diagnostic work up of patients with suspected PE, approaches to mitigate these pitfalls and incidental pulmonary embolism.
肺栓塞 (PE) 可表现出广泛的临床症状,这些症状与其他心血管疾病有很大的重叠。为了避免与 PE 相关的发病率和死亡率,准确且及时地识别这种疾病至关重要。已经制定了一些临床标准来规范疑似 PE 患者的诊断方法。计算机断层扫描肺动脉造影显著提高了肺栓塞的检出率,被认为是诊断这种疾病的首选影像学方法。然而,这种方法存在一些潜在的陷阱,这使得 PE 的诊断具有挑战性。在这篇综述中,我们将讨论在疑似 PE 患者的诊断工作中经常遇到的各种陷阱,以及减轻这些陷阱和偶然发现的肺栓塞的方法。