CTICasesPulmonary Embolism on a Low-Contrast Non-CTPA Study
Imaging findings
A CT that was not a dedicated PE study shows low pulmonary arterial opacification (a region measured a mean near the teens to 130 HU), yet pulmonary emboli are still visible within the arteries. There are accompanying peripheral areas of pulmonary hemorrhage and hemorrhagic infarction on lung and mediastinal windows.
Key takeaways
Even a non-dedicated CT with low pulmonary arterial contrast should not be dismissed for pulmonary embolism, as emboli remain detectable and there is no magic attenuation threshold below which PE can be excluded. Recognizing associated peripheral hemorrhage or hemorrhagic infarction can prompt a second look at the pulmonary arteries where the embolus is then found.
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