Pulmonary artery angiography

Pulmonary angiography is the gold standard for the diagnosis of PE. However, it is an invasive test that involves injection of radiopaque contrast dye into the pulmonary artery. The test is expensive and associated with a significant risk of mortality. 

Radiographic contrast studies are the most accurate and reliable method for diagnosis of VTE. Contrast venography allows visualization of the entire venous system in the lower extremity and abdomen. Pulmonary angiography allows visualization of the pulmonary arteries. The diagnosis of VTE can be made if there is a persistent intraluminal filling defect on multiple x-ray films. 

The cardiac catheterization procednre reqnires vascnlar access, nsually obtained percutaneonsly at brachial or femoral arteries or veins. Left-sided catheterization provides access to the aorta, left ventricle, and left atrinm. Right-sided catheterization enables the right side of the heart, coronary sinus, pulmonary arteries, and pulmonary wedge position to be reached. Left-sided catheterization is used for coronary angiography and ventriculography, whereas rightsided catheterization is nsed for determination of cardiac performance parameters. 

In some centers, a complete diagnostic pulmonary angiography is performed prior to embolotherapy [78]. Selective injections in right and left pulmonary arteries in standard, oblique, and lateral projections are obtained. Outpatient pulmonary angiography in patients with diffuse PAVMs provides a basis for deciding which side to occlude first, to detail the anatomy, determine the best projection for occluding the PAVMs, and measure the feeding pedicles which helps to select the occlusion technique [76, 78]. 

Basoglu T, Canbaz F, Bernay 1, et al. Bilateral pulmonary artery aneurysms in a patient with Behjet s syndrome evaluation with radionuclide angiography and V/Q lung scanning. Clin Nucl Med 1998 23(ll) 735-738. 

Mahnaken AH, Breuer C, Haage P (2001) Silicosis-induced pulmonary artery stenosis demonstration by MR angiography and perfusion MRI. Br J Radiol 74 859-861 Marchiori E, Ferreira A, Muller NL (2001) Silicoproteinosis high-resolution CT and histologic findings. J Thorac Imaging 16 127-129... 

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