CTICasesFlow-Related Pseudo-PE Artifact
Imaging findings
CT angiography shows a persistent, apparent filling defect in the right lower lobe pulmonary artery. However, this is located within a region of severe fibrotic lung disease (NSIP pattern) showing delayed perfusion, representing a flow-related pseudo-PE artifact.
Key takeaways
In patients with severe interstitial lung disease (like NSIP), localized fibrosis can cause increased vascular resistance and delayed flow in the pulmonary arteries. During CTPA, this delayed flow can result in incomplete contrast mixing, creating a pseudo-PE filling defect that must be distinguished from true thromboembolism.
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