Pulmonary artery CTA.

The latest with the introduction of multidetector row computed tomography (MDCT), CT has been firmly established as the modality of choice for imaging the pulmonary arteries, particularly as the de facto first line test for imaging patients with suspected acute pulmonary embolism (PE). Before the introduction of MDCT, remaining concerns regarding CTs accuracy for diagnosis of isolated peripheral emboli had prevented the unanimous acceptance of this test as the reference standard for imaging PE. After a decade of uncertainty, there is now conclusive evidence that CT, if positive, provides reliable confirmation of the presence of PE and, more importantly, if negative effectively rules out clinically significant PE. Current endeavors to streamline and facilitate workflow for CT diagnosis of PE will further improve the acceptance, utility, and importance of this test. Examples include improvements in workflow, CT derivation of right ventricular function parameters for triage and prognostication of patients with acute PE and the comprehensive assessment of patients with acute chest pain for PE, coronary disease, aortic disease, and pulmonary disease by means of a single, contrast enhanced, ECG-synchronized CT scan. Although the diagnosis or exclusion of acute PE is the most common and important application of CT pulmonary angiography, the ease of scan acquisition and the high spatial resolution of modern CT techniques make this test ideally suited for the greatest majority of congenital and acquired, acute and chronic disorders of the pulmonary arteries.