Table 6 Positive and negative aspects of diagnostic modalities for PE
Imaging modality | Main indications and advantages | Main disadvantages |
|---|---|---|
Echocardiography | First and most common diagnostic method due to: Availability, Safety, low cost, applicability at the bedside Widely used for follow-up of PE | Not well-performed in tissue characterization Dependent on the skills of the operator Restricted ability in cases of obesity, obstructive lung diseases, and after cardiothoracic surgery Limited window and narrow field of view |
CT scan | Better anatomical visualization compared to echocardiography Suitable in cases of the possibility of the presence of pathology in adjacent tissues or organs, such as cancers Used for the planning before cardiothoracic surgeries High performance in the detection of pericardial calcifications | Use ionizing radiation or contrast (in cases needing anatomical evaluation). Therefore, it is mostly possible for retrospective gated studies It is only practical in hemodynamically stable patients and those who can hold their breaths The temporal resolution is limited |
MRI | It is mostly used for better anatomical evaluation and characterization | Specific features are required, such as hemodynamic stability, being able to hold breaths, and GFR ≥ 30 in cases of Gadolinium-contrast need Not possible in some cases with metal devices in the thorax, such as some pacemakers or defibrillators Not capable of visualizing lung tissue or calcification with an appropriate sensitivity and quality High cost and lower availability |