What are the ACR guidelines for detection of 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

In its 2011 guidelines, the American College of Radiology (ACR) considers

multislice CT pulmonary angiography to be the standard of care for the detection of pulmonary embolism (PE). Additional recommendation include the following [69] :

  • A chest radiograph cannot exclude or confirm PE, but it is important (as a complementary study) as it can guide further investigations and suggest alternative diagnoses.
  • Any test that can confirm either deep venous thrombosis (DVT) (ie, lower-extremity venous duplex) or PE is sufficient. Only certain studies, however, have sufficient accuracy to exclude PE.
  • Ventilation/perfusion (V/Q) scanning appears to have high overall accuracy.
  • In pregnancy, with radiation a particular concern, the choice between perfusion scanning and CT pulmonary angiography depends on local equipment and expertise, as well as patient factors (normal chest radiograph, ability to breathhold).

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