Abstract

The diagnosis of pulmonary embolism (PE) is often made more challenging by the presence of diseases that can mimic thromboembolic disease. There is no specific or sensitive constellation of clinical signs or symptoms that can be used to diagnose PE. Ventilation/perfusion scans can have false-positive findings related to mediastinal conditions that can compress the pulmonary arteries, and pulmonary hemorrhage can resemble PE on V/Q scanning with potentially devastating consequences if anticoagulation is started. CT-scan related issues leading to potential false-positive diagnoses range from inadequate imaging technique, to systemic-pulmonary shunting, to non-thrombotic occlusion of pulmonary arteries by tumor, septic emboli, and emboli of fat, air, and foreign material, as well as vasculitic processes. Careful assessment of the patient and consideration of these potential mimickers is imperative to correct diagnosis of this potentially life-threatening condition.

摘要

由于存在可模拟血栓栓塞性疾病的疾病，肺栓塞 (PE) 的诊断通常更具挑战性。没有可用于诊断 PE 的一组特定或敏感的临床体征或症状。通气/灌注扫描可能会出现与可压迫肺动脉的纵隔疾病相关的假阳性结果，并且肺出血可能类似于 V/Q 扫描中的 PE，如果开始抗凝，可能会造成破坏性后果。导致潜在假阳性诊断的 CT 扫描相关问题包括成像技术不足、系统肺分流、肿瘤、脓毒性栓塞和脂肪、空气和异物栓塞对肺动脉的非血栓性闭塞，如以及血管炎过程。