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Acute Pulmonary Thromboembolic Disease
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Pulmonary embolism (PE)
            • Definitions

              • Embolized thrombus to pulmonary arteries, often originating in lower extremity or abdominopelvic veins

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Nuclear Medicine Findings

                        • Ultrasonographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Ahuja J et al: In situ pulmonary artery thrombosis: unrecognized complication of radiation therapy. AJR Am J Roentgenol. 215(6):1329-34, 2020
                                              2. Lang M et al: Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis. 20(12):1365-6, 2020
                                              3. Martinez Licha CR et al: Current management of acute pulmonary embolism. Ann Thorac Cardiovasc Surg. 26(2):65-71, 2020
                                              4. Henry TS et al: Smoke: How to differentiate flow-related artifacts from pathology on thoracic computed tomographic angiography. J Thorac Imaging. 34(5):W109-20, 2019
                                              5. McDermott S et al: Should dual-energy computed tomography pulmonary angiography replace single-energy computed tomography pulmonary angiography in pregnant and postpartum patients? J Comput Assist Tomogr. 42(1):25-32, 2018
                                              6. Johns CS et al: Pulmonary MR angiography and perfusion imaging-a review of methods and applications. Eur J Radiol. 86:361-0, 2017
                                              7. Sista AK et al: Stratification, imaging, and management of acute massive and submassive pulmonary embolism. Radiology. 284(1):5-24, 2017
                                              8. Di Nisio M et al: Deep vein thrombosis and pulmonary embolism. Lancet. 388(10063):3060-73, 2016
                                              9. Otrakji A et al: Dual-energy CT: spectrum of thoracic abnormalities. Radiographics. 36(1):38-52, 2016
                                              10. Devaraj A et al: Diagnosing acute pulmonary embolism with computed tomography: imaging update. J Thorac Imaging. 30(3):176-92, 2015
                                              11. Henzler T et al: CT imaging of acute pulmonary embolism. J Cardiovasc Comput Tomogr. 5(1):3-11, 2011
                                              12. Mamlouk MD et al: Pulmonary embolism at CT angiography: implications for appropriateness, cost, and radiation exposure in 2003 patients. Radiology. 256(2):625-32, 2010
                                              13. Shahir K et al: Pulmonary embolism in pregnancy: CT pulmonary angiography versus perfusion scanning. AJR Am J Roentgenol. 195(3):W214-20, 2010
                                              14. Pahade JK et al: Quality initiatives: imaging pregnant patients with suspected pulmonary embolism: what the radiologist needs to know. Radiographics. 29(3):639-54, 2009
                                              15. Ridge CA et al: Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy. AJR Am J Roentgenol. 193(5):1223-7, 2009
                                              16. Revel MP et al: Is It possible to recognize pulmonary infarction on multisection CT images? Radiology. 244(3):875-82, 2007
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Pulmonary embolism (PE)
                                                        • Definitions

                                                          • Embolized thrombus to pulmonary arteries, often originating in lower extremity or abdominopelvic veins

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Angiographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Ultrasonographic Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Ahuja J et al: In situ pulmonary artery thrombosis: unrecognized complication of radiation therapy. AJR Am J Roentgenol. 215(6):1329-34, 2020
                                                                                          2. Lang M et al: Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis. 20(12):1365-6, 2020
                                                                                          3. Martinez Licha CR et al: Current management of acute pulmonary embolism. Ann Thorac Cardiovasc Surg. 26(2):65-71, 2020
                                                                                          4. Henry TS et al: Smoke: How to differentiate flow-related artifacts from pathology on thoracic computed tomographic angiography. J Thorac Imaging. 34(5):W109-20, 2019
                                                                                          5. McDermott S et al: Should dual-energy computed tomography pulmonary angiography replace single-energy computed tomography pulmonary angiography in pregnant and postpartum patients? J Comput Assist Tomogr. 42(1):25-32, 2018
                                                                                          6. Johns CS et al: Pulmonary MR angiography and perfusion imaging-a review of methods and applications. Eur J Radiol. 86:361-0, 2017
                                                                                          7. Sista AK et al: Stratification, imaging, and management of acute massive and submassive pulmonary embolism. Radiology. 284(1):5-24, 2017
                                                                                          8. Di Nisio M et al: Deep vein thrombosis and pulmonary embolism. Lancet. 388(10063):3060-73, 2016
                                                                                          9. Otrakji A et al: Dual-energy CT: spectrum of thoracic abnormalities. Radiographics. 36(1):38-52, 2016
                                                                                          10. Devaraj A et al: Diagnosing acute pulmonary embolism with computed tomography: imaging update. J Thorac Imaging. 30(3):176-92, 2015
                                                                                          11. Henzler T et al: CT imaging of acute pulmonary embolism. J Cardiovasc Comput Tomogr. 5(1):3-11, 2011
                                                                                          12. Mamlouk MD et al: Pulmonary embolism at CT angiography: implications for appropriateness, cost, and radiation exposure in 2003 patients. Radiology. 256(2):625-32, 2010
                                                                                          13. Shahir K et al: Pulmonary embolism in pregnancy: CT pulmonary angiography versus perfusion scanning. AJR Am J Roentgenol. 195(3):W214-20, 2010
                                                                                          14. Pahade JK et al: Quality initiatives: imaging pregnant patients with suspected pulmonary embolism: what the radiologist needs to know. Radiographics. 29(3):639-54, 2009
                                                                                          15. Ridge CA et al: Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy. AJR Am J Roentgenol. 193(5):1223-7, 2009
                                                                                          16. Revel MP et al: Is It possible to recognize pulmonary infarction on multisection CT images? Radiology. 244(3):875-82, 2007