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Incidental Detection of Pulmonary Emboli on Routine MDCT of the Chest

¹ Department of Radiology, University of Chieti, Ospedale Clinicizzato "SS. Annunziata," Via dei Vestini, Chieti 66013, Italy.
² Present address: Department of Radiology, Ospedale di Bassano del Grappa Via dei Lotti, Bassano del Grappa (VI) 36100, Italy.

View larger version (95K): [in a new window]   Fig. 1A. —64-year-old woman with unsuspected pulmonary embolism in segmental artery of right lower lobe. Partial filling defect in posterior basal segmental artery of right lower lobe (arrow, B) that was not seen on CT image viewed with standard mediastinal window settings (A); however, it was identified on image viewed with wider window settings (B).

View larger version (84K): [in a new window]   Fig. 1B. —64-year-old woman with unsuspected pulmonary embolism in segmental artery of right lower lobe. Partial filling defect in posterior basal segmental artery of right lower lobe (arrow, B) that was not seen on CT image viewed with standard mediastinal window settings (A); however, it was identified on image viewed with wider window settings (B).

View larger version (53K): [in a new window]   Fig. 2A. —70-year-old man with lung cancer and silent pulmonary embolism in segmental artery of right lower lobe. CT scan obtained through right lower lobe shows partial filling defect in lateral basal segmental artery (arrow). This was not seen at time of CT, and diagnosis of pulmonary embolism was missed.

View larger version (55K): [in a new window]   Fig. 2B. —70-year-old man with lung cancer and silent pulmonary embolism in segmental artery of right lower lobe. CT scans obtained 3 months later show progression of pulmonary embolism with multiple filling defects in segmental arteries of right lower lobe (B) and in right middle and inferior lobar arteries (C). Pulmonary embolism was correctly diagnosed at this time.

View larger version (65K): [in a new window]   Fig. 2C. —70-year-old man with lung cancer and silent pulmonary embolism in segmental artery of right lower lobe. CT scans obtained 3 months later show progression of pulmonary embolism with multiple filling defects in segmental arteries of right lower lobe (B) and in right middle and inferior lobar arteries (C). Pulmonary embolism was correctly diagnosed at this time.

View larger version (65K): [in a new window]   Fig. 3. —56-year-old man with pulmonary metastases from colon carcinoma and isolated segmental pulmonary embolism. CT scan through left upper lobe shows partial filling defect (arrow) in anterior segmental artery. This finding was missed by reporting radiologist at time of CT.

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