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CT ANGIOGRAPHY PULMONARY

INDICATIONS

INDICATIONS (1,2)

From ACR Criteria:

  • Suspected pulmonary embolism (PE)

  • Pulmonary embolism (PE) suspected

    • High pre-test probability, initial imaging

    • Intermediate pre-test probability, positive D-dimer, initial imaging

    • Low pre-test probability, positive D-dimer, initial imaging pregnant, initial imaging 

Pathology Demonstrated

PATHOLOGY DEMONSTRATED (1,2)

  • Pulmonary embolism

  • Pulmonary hypertension

Patient Preparation

PATIENT PREPARATION

  • Patient able to lie still for ten minutes

  • Not claustrophobic (sedation may be given)

  • Cognitively capable of following basic instructions

  • Metal artefacts removed from the region of interest, including bra’s and necklaces

  • No respiratory distress when lying supine

  • Not allergic to Iodine based Contrast

  • No known kidney disease (eGFR below 30 as per RANZCR), however, acute setting consultant may sign to continue with poor renal function

  • No hyperthyroidism, may induce thyroid storm

  • Patient to have 18G cannula in anterior cubital fossa to enable a 7ml/s flow rate (20G cannula acceptable if flushing to 5ml/s).

  • Preferably patient fasted for 4 hours

ANATOMY INCLUDED

ANATOMY INCLUDED
 

coronal soft.gif
CTPA - Axial (MIP)
axial soft.gif
CTPA - Coronal (MIP)
sagittal soft.gif
CTPA - Sagittal (MIP)
axial lung.gif
CTPA - Axial (Lung Window)
coronal lung.gif
CTPA - Coronal (Lung Window)

REFERENCES

1. American College of Radiology (ACR). Appropriateness Criteria. [Internet]. 2022 [Updated 2021, cited 10 Aug 2022]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria​

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2. Radiopaedia. CT Pulmonary Angiogram (Protocol) [Internet]. 2008 [updated 7 April 2022, cited 10 Oct 2022]. Available from https://radiopaedia.org/articles/ct-pulmonary-angiogram-protocol

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