This is an education resource only. Ordering of all procedure codes on this website are subject to the Canberra Health Services guidelines for imaging orders.
CT ANGIOGRAPHY PULMONARY
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 (1,2)
-
Pulmonary embolism
-
Pulmonary hypertension
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
CTPA - Axial (MIP)
CTPA - Coronal (MIP)
CTPA - Sagittal (MIP)
CTPA - Axial (Lung Window)
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​
​
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
​​