Which statement about PE testing is supported by the material?

• A. Spiral CT is the most reliable test for PE
• B. Pulmonary Angiography is the gold standard for PE
• C. V/Q Scan is never used for PE
• D. D-Dimer alone confirms PE

Answer: (A)

In assessing suspected PE, the goal is to confirm the presence of a clot with a test that is both reliable and practical. Spiral CT angiography directly visualizes thrombi in the pulmonary arteries and offers high sensitivity and specificity, making it the most reliable and widely used imaging choice in contemporary practice. It is fast, accessible, and less invasive than catheter-based pulmonary angiography, which, while historically considered definitive, carries greater risk and procedural complications.

D-dimer serves as a screening tool: it rises with clot formation but is not specific to PE and cannot confirm the diagnosis on its own, so a positive D-dimer does not prove PE and a negative one can help rule out PE in low-risk patients. V/Q scanning can be useful, particularly when CT contrast is contraindicated or in certain populations, but its results can be nondiagnostic or less definitive than CT in many patients. Therefore, the statement about spiral CT being the most reliable test aligns with current practice and supporting data.