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This slide summarizes the constant evolution of MDCT throughout the years. In 1992, Elscint introduced double detector CT. It was possible to acquire the pulmonary arteries in 25 seconds, using 2.7 mm slice thickness. In 1998, 4-slice CT was available and for the first time, it was possible to acquire the entire chest in millimetric slice thickness and one breath-hold. The ubsegmental compartment of the pulmonary circulation was accessible. In 2002, 16-slice CT was available and the entire chest was scanned in more or less 10 seconds and submillimetric slice thickness. In 2004 and more recently 40 and 64 slice units have emerged. The application of cardiac synchronisation permits to freeze the cardiac movements and better delineate the paracardiac zones.
If we add rows of detectors and we increase the spatial resolution, we have demonstrated that 4-slice spiral CT was able to analyse most of subsegmental PE and even more distal pulmonary arteries.
Concerning the diagnostic accuracy of MDCT, studies are rare because pulmonary angiography is imperfect compared to spiral CT and clinicians do not order any more diagnostic pulmonary angiography.