CTICasesAcute Pulmonary Embolism and Pulmonary Infarction on MRA
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Imaging findings
Chest radiograph shows a wedge-shaped consolidation in the posterior left lower lobe. Pulmonary magnetic resonance angiography demonstrates a persistent filling defect within the right lower lobe pulmonary artery along with corresponding segmental perfusion defects in the right lower lobe and left upper lobe. Post-contrast T1-weighted images show a wedge-shaped area of non-perfusing lung and hemorrhage in the left lower lobe, consistent with pulmonary infarction.
Key takeaways
Contrast-enhanced pulmonary MRA is a highly effective, radiation-free alternative to CT angiography for diagnosing acute pulmonary embolism and associated complications in young female patients, especially those on oral contraceptives. MRA can demonstrate both direct filling defects and corresponding regional perfusion defects, as well as pulmonary infarction and hemorrhage.
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