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Six Cases of Acute Central Pulmonary Embolism Revealed on Unenhanced Multidetector CT of the Chest

Jeffrey P. Kanne1, Michael B. Gotway2, Nisa Thoongsuwan3 and Eric J. Stern3

1 Department of Radiology, University of Washington Medical Center, University of Washington School of Medicine, 1959 N.E. Pacific St., Box 357115, Seattle, WA 98195-7115.
2 Department of Radiology, Thoracic Imaging Section, San Francisco General Hospital, University of California, San Francisco, 1001 Potrero Ave., Rm. 1X 55A, Box 1325, San Francisco, CA 94110.
3 Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Ave, Box 359728, Seattle, WA 98104-2499.



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  		Fig. 1A. –67-year-old man with syncopal episode 1 month after hemicolectomy for colon adenocarcinoma. Unenhanced multidetector CT (MDCT) scan shows bilateral central high-attenuation emboli (arrows). Average CT attenuation is 70 H.

 


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  		Fig. 1B. –67-year-old man with syncopal episode 1 month after hemicolectomy for colon adenocarcinoma. Enhanced MDCT scan also shows central pulmonary emboli.

 


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  		Fig. 2A. –63-year-old man with diabetes, congestive heart failure, and recent immobilization. Unenhanced multidetector CT (MDCT) scan shows high-attenuation emboli in right main pulmonary artery (asterisk). Average CT attenuation is 77 H.

 


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  		Fig. 2B. –63-year-old man with diabetes, congestive heart failure, and recent immobilization. Enhanced MDCT scan also shows central pulmonary embolus.

 


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  		Fig. 3A. –52-year-old man 3 days after placement of ventriculoperitoneal shunt. Unenhanced multidetector CT (MDCT) scan shows high-attenuation "saddle" embolus (arrow).

 


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  		Fig. 3B. –52-year-old man 3 days after placement of ventriculoperitoneal shunt. Enhanced MDCT scan also shows saddle pulmonary embolus.

 


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  		Fig. 4A. –65-year-old woman with Stanford type A aortic dissection. Unenhanced multidetector CT (MDCT) scan shows bilateral high-attenuation central pulmonary emboli (white arrows) and aortic intimal flap (black arrow).

 


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  		Fig. 4B. –65-year-old woman with Stanford type A aortic dissection. Enhanced MDCT scan shows central pulmonary emboli and aortic intimal flap.

 

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