CTICasesPulmonary Air Embolism
Imaging findings
Chest CT angiography demonstrates a localized filling defect within a segmental branch of the right pulmonary artery, associated with slow flow of contrast. On lung windows, the defect is confirmed to represent a pocket of gas (air) within the arterial lumen. A follow-up scan the next day shows complete resolution of the filling defect, confirming iatrogenic air embolism.
Key takeaways
Venous air embolism is a well-recognized iatrogenic pitfall on chest CT, occurring when small bubbles of air are inadvertently introduced during intravenous contrast injection. The air lodges in the pulmonary arteries and can mimic an acute pulmonary embolism on soft-tissue windows. Viewing on lung windows reveals the gas density (-1000 HU) and confirms the diagnosis.
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