title: [Diagnostics of acute pulmonary embolism : An update].
abstract: Pulmonary embolism is an acute and potentially life-threatening condition requiring a differentiated diagnostic algorithm. Assessment of the risk and clinical probability are of utmost importance in order to initiate early treatment or to reliably exclude a pulmonary embolism. Computed tomography of the pulmonary arteries (CTPA) has become the non-invasive gold standard for the diagnostic approach. Alternatively, scintigraphy can also be used. A negative CTPA excludes a pulmonary embolism with a high degree of probability. Furthermore, CTPA can supply additional information, such as estimation of the right ventricular strain (right ventricular dysfunction, RVD) or alternative diagnoses if pulmonary embolism has been ruled out as the primary cause of symptoms. An essential prerequisite is a high quality CTPA with sufficient contrast enhancement in the pulmonary arteries, avoidance of artifacts and optimization of both the radiation dosage as well as the amount of contrast medium, individually determined for each patient.
authors.affiliation: Department of Radiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. m.das@mumc.nl.
authors.forename: M
authors.initials: M
authors.lastname: Das
authors.affiliation: Department of Radiology, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Wildberger
mesh_terms: D000208:Acute Disease; D000792:Angiography / Q000379:methods*; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Computed tomography; Perfusion scintigraphy; Pregnancy; Pulmonary embolism; Right ventricular dysfunction