CTICasesLeft ventricular thrombus
Imaging findings
Early arterial phase CT pulmonary angiogram shows a blood-contrast level and heterogeneous contrast enhancement in the left ventricle mimicking a thrombus or mixing artifact. Delayed phase imaging confirms a large, persistent left ventricular thrombus at the apex, secondary to an old myocardial infarction.
Key takeaways
In patients with severe left ventricular dysfunction and delayed transit time, slow-flowing blood can layer and mimic or mask an apical left ventricular thrombus on early-phase CT. Obtaining delayed-phase imaging is crucial to differentiate thrombus from mixing/slow-flow artifact.
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