Air Trapping on CT of Patients with Pulmonary Embolism
Hiroaki Arakawa1,2,
Yasuyuki Kurihara1,
Kaoru Sasaka1,
Yasuo Nakajima1 and
W. Richard Webb3
1 Department of Radiology, St. Marianna University School of Medicine, 2-16-1
Sugao, Miyamae-Ku, Kawasaki City, 216-8511 Japan.
2 Present address: Department of Radiology, Dokkyo University School of
Medicine, Mibu, Shimotsuga-gun, Tochigi, 321-0293 Japan.
3 Department of Radiology, University of California San Francisco, 505 Parnassus
Ave., San Francisco, CA 94143-0628.

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Fig. 1A. Acute pulmonary embolism in 76-year-old woman. Helical CT
angiogram (3-mm collimation) shows clot (arrowhead) in posterior
segmental arteries of right upper lobe. Clot was not identified in arteries of
left upper lobe.
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Fig. 1B. Acute pulmonary embolism in 76-year-old woman. Helical CT
angiogram obtained using lung window settings shows inhomogeneous lung
attenuation (arrows) in both upper lobes. Vessel size in lower
attenuation areas is only slightly reduced, thus indicating mosaic perfusion
as possible cause of inhomogeneous lung attenuation.
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Fig. 1C. Acute pulmonary embolism in 76-year-old woman. Expiratory
high-resolution CT scan obtained at same level as B shows air trapping
to be associated with mosaic perfusion in both upper lobes. Air trapping in
left upper lobe closely corresponds to area of low attenuation seen on
inspiratory scan (B). In right upper lobe, area of air trapping appears
larger than area of mosaic perfusion seen on inspiratory scan.
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Fig. 2A. Acute embolism in 68-year-old woman with deep vein
thrombosis. Helical CT angiogram shows massive thromboembolism in right
descending pulmonary artery and its branches in lower lobes. Clot
(arrow) is also visualized in artery leading to left lingula. Clot
was also identified in segmental arteries in left lower lobe (not shown).
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Fig. 2B. Acute embolism in 68-year-old woman with deep vein
thrombosis. Helical CT angiogram obtained using lung window settings shows
inhomogeneous lung attenuation with peripheral ground-glass opacity
(arrows) in both lower lobes.
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Fig. 2C. Acute embolism in 68-year-old woman with deep vein
thrombosis. Expiratory high-resolution CT scan obtained at same level as
B shows multifocal areas of air trapping distal to arteries with
clots.
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Fig. 3A. Acute embolism in 61-year-old woman with chronic pulmonary
embolism. Helical CT angiogram shows eccentric clots (arrows) in both
lower lobe pulmonary arteries.
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Fig. 3B. Acute embolism in 61-year-old woman with chronic pulmonary
embolism. Helical CT angiogram obtained using lung window settings shows near
normal lung attenuation. Focal pleural-based ground-glass attenuation
(arrow) is visible in right lower lobe.
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Fig. 3C. Acute embolism in 61-year-old woman with chronic pulmonary
embolism. Expiratory high-resolution CT scan obtained at same level as
B shows extensive areas of air trapping (arrows) distal to
arteries with clots.
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Fig. 4A. Acute pulmonary embolism in 45-year-old woman. Helical CT
angiogram obtained at level between aortic arch and tracheal carina shows clot
(arrowhead) in segmental artery of right upper lobe, but no clot was
identified in left side.
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Fig. 4B. Acute pulmonary embolism in 45-year-old woman. Helical CT
angiogram obtained above aortic arch using lung window settings shows small
area of lower attenuation (arrows) in left upper lobe.
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Fig. 4C. Acute pulmonary embolism in 45-year-old woman. Expiratory
high-resolution CT scan obtained at same level as B shows extensive
areas of air trapping in both upper lobes (arrows). Areas of air
trapping are more widespread than areas of mosaic perfusion shown on
B.
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Copyright © 2002 by the American Roentgen Ray Society.