SPIRAL CT OF PULMONARY-EMBOLISM - DIAGNOSTIC-APPROACH, INTERPRETIVE PITFALLS AND CURRENT INDICATIONS

modified the diagnostic work-up of pulmonary embolism, because it is p ossible to depict noninvasively endoluminal clots in second- to-fourth -division pulmonary arteries. If this technique is currently considere d a powerful imaging alternative for the detection of acute central em boli, it is mainly related to the possibility to obtain a uniform and high degree of arterial enhancement of pulmonary arteries down to 2-3 mm diameter. Minimal experience in spiral CT angiography is necessary to achieve this goal and requires familiarity with both data acquisiti on and contrast medium injection. Numerous interpretive pitfalls exist in assessing spiral CT images, and certain caveats have to be heeded. However, their recognition becomes increasingly less problematic as t he radiologist gains experience with spiral CT of the pulmonary vascul ature. Therefore, the purpose of this article is to review the diagnos tic approach to pulmonary embolism with spiral CT, with special emphas is on protocol parameters and scan interpretation.