What is an indication for pulmonary arteriography?

• A. Pulmonary embolus
• B. Coronary artery disease
• C. Aortic dissection
• D. Pneumothorax

Answer: (A)

Pulmonary arteriography is used to directly visualize the pulmonary arterial system with contrast, making it the test of choice when you need definitive evidence of an intraluminal obstruction in the lungs’ arteries. The classic indication is suspected pulmonary embolism: if there is a high clinical probability but noninvasive tests are inconclusive, catheter-based angiography can confirm a filling defect consistent with an embolus and guide further treatment. This invasive test provides precise detail about the location and extent of any blockage, which is crucial for planning interventions or surgeries in certain cases.

The other conditions listed involve different vascular or thoracic structures. Coronary artery disease is diagnosed with coronary angiography of the heart’s arteries, not the pulmonary arteries. Aortic dissection is evaluated with imaging that visualizes the aorta, such as CT angiography or transesophageal echo, rather than pulmonary arteriography. Pneumothorax is detected mainly by chest X-ray or ultrasound, not by imaging the pulmonary arteries.