How is pulmonary angiography performed to diagnose pulmonary embolism (PE)?

Updated: Jun 06, 2019
  • Author: Daniel R Ouellette, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Pulmonary angiography is the historical criterion standard for the diagnosis of pulmonary embolism. Following injection of iodinated contrast, anteroposterior, lateral, and oblique studies are performed on each lung. Positive results consist of a filling defect or sharp cutoff of the affected artery (as shown in the image below). Nonocclusive emboli are described as having a tram-track appearance. Abnormal findings on V/Q scans performed prior to angiography guide the operator to focus on abnormal areas.


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