What is the gold standard for the diagnosis of pulmonary embolism?

The gold standard for the diagnosis of pulmonary embolism is the pulmonary angiogram. This imaging study is highly effective in directly visualizing the blood vessels in the lungs. By injecting a contrast dye into the pulmonary arteries, the pulmonary angiogram can clearly identify any obstructions or blockages caused by blood clots. This allows healthcare providers to confirm the presence of a pulmonary embolism definitively.

While other diagnostic methods, such as ultrasound of the legs, can help identify deep vein thrombosis (DVT) as a potential source of pulmonary embolism, they do not directly assess the pulmonary vasculature. Chest X-rays and ventilation-perfusion (V/Q) scans can assist in the evaluation of pulmonary embolism but are less definitive. The chest X-ray is often used to rule out other conditions, while a V/Q scan can suggest the likelihood of a pulmonary embolism but does not provide a definitive diagnosis. Therefore, the pulmonary angiogram remains the most reliable method for confirming the presence of a pulmonary embolism.