Imaging of acute pulmonary embolism: An update

Alastair J.E. Moore, Jason Wachsmann, Murthy R. Chamarthy, Lloyd Panjikaran, Yuki Tanabe, Prabhakar Rajiah

Research output: Contribution to journalReview articlepeer-review

124 Scopus citations


Imaging plays an important role in the evaluation and management of acute pulmonary embolism (PE). Computed tomography (CT) pulmonary angiography (CTPA) is the current standard of care and provides accurate diagnosis with rapid turnaround time. CT also provides information on other potential causes of acute chest pain. With dual-energy CT, lung perfusion abnormalities can also be detected and quantified. Chest radiograph has limited utility, occasionally showing findings of PE or infarction, but is useful in evaluating other potential causes of chest pain. Ventilation-perfusion (VQ) scan demonstrates ventilation-perfusion mismatches in these patients, with several classification schemes, typically ranging from normal to high. Magnetic resonance imaging (MRI) also provides accurate diagnosis, but is available in only specialized centers and requires higher levels of expertise. Catheter pulmonary angiography is no longer used for diagnosis and is used only for interventional management. Echocardiography is used for risk stratification of these patients. In this article, we review the role of imaging in the evaluation of acute PE.

Original languageEnglish (US)
Pages (from-to)225-243
Number of pages19
JournalCardiovascular Diagnosis and Therapy
Issue number3
StatePublished - Jun 2018


  • Acute
  • Angiography
  • Clot
  • Computed tomography (CT)
  • Dual-energy
  • Embolism
  • Magnetic resonance imaging (MRI)
  • Nuclear
  • Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED)
  • Ventilation-perfusion (VQ)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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