Optimal CTA Reporting for Acute Pulmonary Embolism

A practical radiology review of Optimal CTA Reporting for Acute Pulmonary Embolism, focused on imaging findings, differential diagnosis, reporting points, and high-yield teaching pearls.

• Consensus by ESC, Fleischner, EACVI, ESTI, STR, ERS (2025).

Purpose & Context

• 》CTA = first-line imaging for suspected acute PE.
• ︎Goal: deliver standardized, prognostically relevant, and actionable reports.

How to Perform CTA

• kV: 80–120 (use automatic low-kV selection if possible).
• Flow rate: ≥4 mL/s (5 mL/s ideal) with ≥20 G antecubital IV access.
• Contrast: 80–100 mL (300–370 mg I/mL).
• Rotation time: shortest possible, section thickness: 1 mm.
• Direction: caudo-cranial in dyspneic patients.
• Reconstruction: iterative or deep-learning.
• Pregnancy: reduce kV (80–100), limit z-axis (diaphragm–aortic top).