Multiple choice

Which of the following is the best investigation in thromboembolism?

  1. D-dimer levels

  2. Multidetector CT angiography

  3. Colour Doppler USG

  4. Catheter angiography

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B Correct answer
Explanation

Multidetector CT pulmonary angiography (CTPA) is the gold standard and best initial investigation for pulmonary thromboembolism. It provides direct visualization of thrombi within the pulmonary arteries with high sensitivity and specificity. D-dimer is sensitive but non-specific - useful for ruling out PE when negative but not diagnostic when positive. Colour Doppler ultrasound is used for detecting deep vein thrombosis in the legs (source of emboli), not the pulmonary embolism itself. Catheter pulmonary angiography is invasive and reserved for cases where CT is contraindicated or inconclusive.

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