EURORAD ESR

Case 13903

Pulmonary infarction: What should I look for?

Author(s)
J.A Prat-Matifoll; C. Ortiz; S. Dyer-Hartnett; E. Pallisa; O. Persiva; D. Varona; J. Andreu Soriano

Vall Hebrón Hospital,
ICS, Radiology;
Passeig Vall Hebrón 116-119
08035 Barcelona, Spain;
Email:joanalbertpratrx@gmail.com
 
Patient
male, 50 year(s)
 
 
  • Figure 1
    X-ray: Emergency room
     

    10 DAYS: A non-specific parenchymal opacity within the right inferior lobe (red arrows) and blurring of the right costophrenic angle (pleural effusion).

     
    Area of Interest: Thorax; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Acute;

    15 DAY: Elis-Daimoseau line in the right costophrenic angle (pleural effusion, green arrow). Slightly enlarged inferior pulmonary artery (yellow arrow).

     
    Area of Interest: Lung; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Contrast-enhanced CT: Thromboembolism
     

    Pulmonary embolism involving the latero-basal and postero-basal arterial branches of the right lower lobe (red arrow).

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Acute;

    Filling defect of the latero-basal and postero-basal branches, caused by a thromboembolism (red arrow).

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: eLearning; Special Focus: Acute;
     
     
  • Figure 3
    Contrast-enhanced CT: Soft-tissue window
     

    Consolidation with diminished enhancement (red arrows) compared to normal enhancement (yellow arrows). Note the abscence of arterial vessels in the right lower lobe compared to normal lung (orange arrow). Bronchogram...

     
    Area of Interest: eHealth; Imaging Technique: CT-Angiography; Procedure: Contrast agent-other; Special Focus: Acute;

    Triangle-shaped consolidation which contains multiple internal air lucencies (red arrows). Diminshed enhancement of the consolidation (yellow arrows = normal enhancement).

     
    Area of Interest: Contrast agents; Imaging Technique: CT-High Resolution; Procedure: Contrast agent-other; Special Focus: Acute;

    Sparing of the anterior basal branch of the inferior lobe and middle lobe artery, with correct enhancement of lung parenchyma (yellow arrows).

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Screening; Special Focus: Acute;

    On a posterior coronal image, the abscence of blood vessels within the unenhanced parenchyma is seen. Normal enhancement of the superior segment (yellow arrows) compared to diminshed enhancement of posterior and basal...

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Special Focus: Acute;
     
     
  • Figure 4
    Contrast-enhanced CT: Lung window
     

    Internal air lucencies (which are not air bronchograms) present within the confluent consolidation (bubbly consolidation).

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Embolisation; Special Focus: Acute;

    Note the peripheral location of the previously mentioned air lucencies within the consolidation.

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Arterial access; Special Focus: Acute;
     
     
  • Figure 5
    Chest X-ray: before being discharged from hospital

    Persistent right lower lobe subtle opacity with a residual linear scar and pleural thickening. Note the normal right costophrenic angle, no pleural effusion.

     
    Area of Interest: Trauma; Imaging Technique: Digital radiography; Procedure: Education; Special Focus: Acute;
     
     
10 DAYS: A non-specific parenchymal opacity within the right inferior lobe (red arrows) and blurring of the right costophrenic angle (pleural effusion).
 
15 DAY: Elis-Daimoseau line in the right costophrenic angle (pleural effusion, green arrow). Slightly enlarged inferior pulmonary artery (yellow arrow).
 
Pulmonary embolism involving the latero-basal and postero-basal arterial branches of the right lower lobe (red arrow).
 
Filling defect of the latero-basal and postero-basal branches, caused by a thromboembolism (red arrow).
 
Consolidation with diminished enhancement (red arrows) compared to normal enhancement (yellow arrows). Note the abscence of arterial vessels in the right lower lobe compared to normal lung (orange arrow). Bronchogram within well-perfused lung (white arrow).
 
Triangle-shaped consolidation which contains multiple internal air lucencies (red arrows). Diminshed enhancement of the consolidation (yellow arrows = normal enhancement).
 
Sparing of the anterior basal branch of the inferior lobe and middle lobe artery, with correct enhancement of lung parenchyma (yellow arrows).
 
On a posterior coronal image, the abscence of blood vessels within the unenhanced parenchyma is seen. Normal enhancement of the superior segment (yellow arrows) compared to diminshed enhancement of posterior and basal segments (red arrows).
 
Internal air lucencies (which are not air bronchograms) present within the confluent consolidation (bubbly consolidation).
 
Note the peripheral location of the previously mentioned air lucencies within the consolidation.
 
Persistent right lower lobe subtle opacity with a residual linear scar and pleural thickening. Note the normal right costophrenic angle, no pleural effusion.
 
 
 
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