CTICasesHyperdense Pulmonary Embolism on Non-Contrast CT
Imaging findings
Non-contrast CT chest shows a wedge-shaped left lower lobe consolidative opacity (infarct) and a small pleural effusion. The main pulmonary arteries contain hyperattenuating (hyperdense) filling defects. Contrast-enhanced CT confirmed a massive saddle pulmonary embolism and a patent foramen ovale (PFO).
Key takeaways
Acute pulmonary embolism can sometimes be detected on non-contrast CT when the thrombus is hyperdense relative to the surrounding unenhanced blood pool. This is particularly noticeable in anemic patients. Associated findings include pulmonary infarction (wedge-shaped subpleural consolidations) and pleural effusion.
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