Role of Multislice Computed Tomography of the Thorax for the Evaluation of Suspected Pulmonary Embolism

In Brief Multidetector computed tomography (MDCT), with its ability to rapidly acquire very thin sections, has become the cornerstone of imaging of pulmonary embolism (PE). Its availability, speed, and high negative predictive value (95–99%) make it an ideal modality for the evaluation of PE. MDCT also allows the concurrent evaluation of a wide variety of other thoracic disorders, including pulmonary parenchymal diseases, aortic dissection, and coronary artery disease. This article discusses attempts to validate computed tomography (CT) as the primary imaging modality for PE using both comparison with angiography as the gold standard and outcomes-based methods. Additionally, the advantages of MDCT over single-detector scanners, CT findings of acute and chronic PE, common CT artifacts, radiation, and CT-PE in pregnancy are discussed. The ability of multidetector computed tomography continues to improve consistently in detecting pulmonary emboli of all sizes and, in the near future, it may be used as a comprehensive examination for a wide variety of chest diseases. This article addresses the validation of computed tomography as the primary imaging modality for pulmonary embolism, advantages of multidetector computed tomography over single-detector scanners, and computed tomography findings of acute and chronic pulmonary embolism. Additionally, the important issues of radiation and CT-PE in pregnancy are discussed.