Comparative Overview of Different Radiological Imaging Techniques in the Diagnosis of Pulmonary Embolism

REVIEW
Zuhal Y. Hamd

 
International Journal of Biomedicine. 2023;13(1):20-25.
DOI: 10.21103/Article13(1)_RA3
Originally published March 3, 2023

Abstract: 

Background: Imaging techniques such as chest X-ray (CXR), computed tomography pulmonary angiography (CTPA), ventilation-perfusion (V/Q) scintigraphy, and magnetic resonance imaging (MRI) are some methods used to detect and manage acute pulmonary embolism (PE). The aim of this review was a comparative analysis of the various imaging techniques used to evaluate PE.
Methods and Results: The incidence, distribution, clinical features, classification of PE and clinical assessment of the current methods for diagnosis of PE were discussed. CTPA is the gold standard for fast turnaround and accurate diagnosis. Additional probable reasons for sudden chest pain can also be learned through a CT scan. Lung perfusion anomalies can be identified and measured using dual-energy CT. Chest radiographs are only marginally beneficial, occasionally revealing PE or infarction signs, but are helpful in ruling out other possible causes of chest pain. These patients' ventilation-perfusion mismatches are evident in the V/Q scan, which has many grading schemes with conventional ranges from normal to high. While MRI, which is only available in specialist facilities and calls for higher degrees of competence, also offers accurate diagnosis.
Conclusion: Early diagnosis and treatment of PE is challenging due to asymptomatic conditions or overlapping symptoms. Diagnosis of PE in expectant mothers and those with suspected PE recurrence is typically difficult. Over-diagnosis and overtreatment, particularly regarding sub-segmental PE, and the lowered clinical suspicion threshold remain a major concern in PE diagnosis. The routine use and integration of the above diagnostic techniques need to be encouraged in clinical practice to overcome the diagnostic hurdles. The introduction of new diagnostic techniques or improved risk stratification processes might enhance the management of PE.

Keywords: 
pulmonary embolism • computed tomography • magnetic resonance imaging • computed tomography pulmonary angiography • ventilation-perfusion scan • chest radiographs
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Received December 12, 2022.
Accepted February 23, 2023.
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