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(Circulation. 2004;109:I-15 – I-21.)
© 2004 American Heart Association, Inc.

Diagnosis of Venous Thromboembolism

Role of Computed Tomography and Magnetic Resonance Imaging for Deep Venous Thrombosis and Pulmonary Embolism

Jeffrey P. Kanne, MD; Tasneem A. Lalani, MD

From the Department of Radiology, University of Washington School of Medicine, Seattle.

Correspondence to Tasneem A. Lalani, MD, Department of Radiology, University of Washington School of Medicine, Box 357115, Seattle WA 98195 to 7115. E-mail tal99{at}u.washington.edu

Abstract

During the 1990s, computed tomography (CT) and magnetic resonance (MR) imaging underwent extensive technological advancement and expanded clinical use in patients with venous thromboembolic disease, particularly with regard to evaluation of the pulmonary vasculature. In many institutions, helical (spiral) CT pulmonary angiography has become the initial imaging study of choice to evaluate patients with suspected pulmonary embolism, supplanting ventilation/perfusion scintigraphy. In addition, CT venography of the pelvis and lower extremities is often incorporated into the CT angiography protocol to identify or exclude concurrent deep venous thrombosis. MR pulmonary angiography and MR venography are second-line diagnostic tools because of their higher cost, limited availability, and other logistical constraints. As the technology improves and becomes more widely available, MR imaging may play a greater role in the evaluation of patients with venous thromboembolic disease.

Key Words: thrombosis • pulmonary heart disease • imaging • MRI