Gefter W B, Hatabu H, Holland G A, Gupta K B, Henschke C I, Palevsky H I
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Radiology. 1995 Dec;197(3):561-74. doi: 10.1148/radiology.197.3.7480717.
Recent technical advances in computed tomography (CT; helical and electron beam) and magnetic resonance (MR) imaging have spurred a renewed interest in these modalities for the diagnosis of acute and chronic pulmonary embolism (PE). These techniques can enable accurate clot detection down to segmental pulmonary arteries, with CT currently allowing more accuracy than that with MR imaging. Ongoing technical advances, particularly in MR angiography, will likely increase diagnostic accuracy. Inability to reliably detect subsegmental acute emboli may not prove to be a clinically significant limitation if lung imaging is coupled with evaluation for deep venous thrombosis. MR imaging can potentially accomplish this within a single examination. Incorporation of CT and MR imaging into diagnostic algorithms for suspected PE can be cost-effective. Evaluation of these new modalities should be based on patient outcome, not solely on clot detectability. Well-designed clinical trials are warranted before CT and MR imaging can be used routinely in the diagnosis of acute PE.
计算机断层扫描（CT；螺旋CT和电子束CT）及磁共振（MR）成像技术的最新进展，激发了人们对这些方式用于诊断急慢性肺栓塞（PE）的新兴趣。这些技术能够准确检测到肺段肺动脉内的血栓，目前CT检测的准确性高于MR成像。正在进行的技术进步，尤其是在磁共振血管造影方面，可能会提高诊断准确性。如果肺部成像与深静脉血栓形成评估相结合，无法可靠检测亚段急性栓子可能不会被证明是一个具有临床意义的限制。MR成像有可能在一次检查中完成这一评估。将CT和MR成像纳入疑似PE的诊断算法中可能具有成本效益。对这些新方式的评估应基于患者的预后，而不仅仅是血栓的可检测性。在CT和MR成像能够常规用于急性PE的诊断之前，需要进行精心设计的临床试验。
