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July 27, 2011

Excluding Pulmonary Embolism With Computed Tomographic Pulmonary Angiography or Ventilation-Perfusion Lung Scanning

JAMA. 2008;299(14):1664-1665. doi:10.1001/jama.299.14.1664-b

To the Editor: The advantage gained by / scanning in having comparable efficacy with CTPA in ruling out clinically significant pulmonary emboli1 might be offset by the inability of / scanning to identify clinically significant disorders, including dissecting aortic aneurysm, which can simulate pulmonary embolism in its clinical2 and biochemical signs3 and in its ability to generate a / mismatch identical to that generated by pulmonary embolism.4 Electrocardiogram-gated 64–multidetector computed tomography angiography may be able to identify both pulmonary embolism and dissecting aortic aneurysm in situations where the origin of chest pain is unclear.5 It should be evaluated against / scanning for its ability to rule out pulmonary embolism.