Know the radiological studies used in the diagnosis of patients suspected of having pulmonary embolism.

You are suspecting that  your patient may have pulmonary embolism. What are the imaging procedures you will consider to make the diagnosis? Which would be your first imaging procedure and why?

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Your first imaging procedure should be chest x-ray


The normal presentation of findings suggestive of PE in CXR

What is the most common radiological manifestation of pulmonary embolism in chest x-ray?

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The rationale for the need for CXR prior to performing lung scan or CT chest

Why do you need current chest x-ray before ordering lung scan?

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Methods for detecting clots in deep veins

What is the common source for pumonary emboism? Which radiological procedure will help you identify that source?

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Value of negative doppler examination in legs. Senstivity of diagnosis for deep vein thrombosis by doppler examination

You order doppler exam of legs to rule out deep vein thrombosis as the source for pulmonary embolism. It is reported negative. How does it alter your management of the case?

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Utility of doppler exam of legs in conjunction with lung scan in deciding on pulmonary angiography

You are suspecting pulmonary embolism in your patient. Chest x-ray is normal. Ventilation perfusion scan is indeterminate. Doppler exam of leg is positive for deep vein thrombosis. What will be your management decision?

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How is ventilation scan accomplished? Rationale behind simultaneous evaluation of ventilation and perfusion scan

What is the principle behind ventilation perfusion scan? How are these procedures performed? Why do you need both ventilation and perfusion scan?

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Probability factor for lung scan interpretation  Interpretation based on probability factor for lung scan

What is the meaning of "probabilty" factor in interpreting ventilation perfusion scans in the evaluation for pulmonary embolism?

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Sensitivity and specificity of spiral CT for central and peripheral clots. Radiological signs of clots in pulmonary vessels in CT. Lung scan vs Spirat CT for diagnosis of pulmonary embolism

How does spiral CT differ from Ventilation perfusion scan in the evaluation of pulmonaty embolism?

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In which group of patients you would consider spiral CT over ventilation perfusion scan for the diagnosis of pulmonary embolism?

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What is the significance of negative spiral CT scan for pulmonary embolism?  Does it rule out pulmonary embolism?

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Will you order spiral CT or ventilation perfusion scan to rule out pulmonary embolism?

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Gold standard for diagnosis of pulmonary embolism

What is the gold standard diagnostic procedure for pulmonary embolism?

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Radiological signs of clots in pulmonary vessels in pulmonary angiogram

What are the radiological findings of pulmonary embolism in pulmonary angiogram?

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Complications of pulmonary angiogram

How is pulmonary angiogram done? What are the complication reported with pulmonary angiogram?

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Risk of pulmonary angiogram in patients with pulmonary hypertension

Your patient has physical findings suggestive of pulmonary hypertension. You have an indeterminate ventilation perfusion scan. a clinical decision is made to go ahead with pulmonary angiogram. How do you think radiologist will proceed?

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Indication for pulmonary angiogram

Do you routinely do pulmonary angiogram in all cases suspected fo having pulmonary angiogram?

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You are going to be presented with clinical scenarios. Decide whether you will request pulomonary angiogram or not.

Normal chest x-ray, High probabilty lung scan.. What is your choice?

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No angiogram.

You have enough evidence to treat this patient


Normal chest x-ray, normal lung scan, negative doppler of legs. What is your choice?

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Normal chest x-ray, Low probability lung scan, positive doppler of legs. What is your choice?

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Chest x-ray consistant with COPD, Intermediate probability lung scan, positive doppler of legs. What is your choice?

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Chest x-ray consistant with COPD, Intermediate probability lung scan, negative doppler of legs. What is your choice?

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