CT for thromboembolic disease

Pulmonary embolism and deep-venous thrombosis are both manifestations of a single disease, venous thromboembolic disease. Historically, diagnosis of the two manifestations has been approached separately, with a range of diagnostic tests, all of which have limitations. Computed tomography (CT) pulmonary arteriography, with the incorporation of indirect venography, is now a single test for both pulmonary embolism and deep-venous thrombosis, CT scanner technology is evolving rapidly, and sensitivity and specificity which are already good, will probably continue to improve. This article reviews continuing treatment dilemmas in thromboembolic disease and presents a diagnostic algorithm that can be used in evaluating patients with suspected thromboembolic disease. Protocol design and image interpretation for CT pulmonary arteriography and indirect venography are discussed.