Comparative Efficacy of Low-Dose CT Pulmonary Angiography Versus Conventional CT Pulmonary Angiography in the Diagnosis and Risk Stratification of Pulmonary Embolism

Abstract

Pulmonary angiography is a crucial diagnostic tool in the evaluation of pulmonary embolism (PE), a condition where blood clots obstruct the pulmonary arteries, potentially leading to serious morbidity and mortality. Traditionally, the gold standard for diagnosing PE has been conventional pulmonary angiography, but recent advancements in imaging technology have integrated this procedure into computed tomography (CT) imaging protocols, significantly enhancing diagnostic accuracy and efficiency. CT pulmonary angiography (CTPA) combines high-resolution imaging with advanced contrast-enhanced techniques to provide detailed visualization of the pulmonary vasculature. By employing iodine-based contrast agents, CTPA enables the precise identification of emboli within the pulmonary arteries. This method has become the first-line imaging technique due to its high sensitivity and specificity, rapid execution, and ability to simultaneously assess other potential causes of respiratory symptoms. CTPA operates on the principle of capturing cross-sectional images of the chest using X-ray technology. The patient is administered a contrast medium, which highlights the blood vessels, making any obstructions clearly visible against the surrounding tissue. The integration of three-dimensional imaging further allows for comprehensive evaluation of the emboli's location, size, and impact on pulmonary circulation. This enhanced visualization aids in the accurate staging of the embolism and informs therapeutic strategies. Despite its advantages, CTPA is not without limitations. Issues such as contrast allergy, renal function impairment, and radiation exposure are notable concerns. However, the development of low-dose protocols and improved contrast agents has mitigated some of these risks. Pulmonary angiography within the CT framework plays a pivotal role in diagnosing and managing pulmonary embolism. Its ability to provide rapid, accurate, and detailed imaging has made it indispensable in modern clinical practice, although ongoing advancements aim to refine its safety and efficacy further.

Keywords: Computed Tomography (CT), Pulmonary Embolism (PE), Contrast-Enhanced Imaging, Diagnostic Accuracy, Imaging Technology, Cross-Sectional Imaging, Iodine-Based Contrast Agents, Sensitivity, Specificity.