Computed tomographic patterns of pulmonary thromboembolism and infarction

Area of Science:

• Radiology
• Pulmonary Medicine
• Diagnostic Imaging

Background:

• Pulmonary infarction, a consequence of pulmonary thromboembolism, presents characteristic imaging findings.
• The wedge-shaped density with its base at the pleura and apex pointing parahilar is a classic sign.
• Computed tomography (CT) offers enhanced visualization compared to plain chest X-rays.

Purpose of the Study:

• To evaluate the utility of CT scanning in detecting the characteristic wedge-shaped pattern of pulmonary infarction.
• To assess the frequency of this specific CT finding in patients with confirmed pulmonary thromboembolism.

Main Methods:

• Retrospective review of CT scans from 16 patients with clinical evidence of pulmonary thromboembolism.
• Analysis of CT patterns, specifically looking for wedge-shaped areas of increased attenuation.
• Corroboration of diagnoses through non-CT based procedures.

Main Results:

• A variety of CT patterns indicating increased attenuation were observed in the patient cohort.
• A distinct wedge-shaped appearance, suggestive of pulmonary infarction, was identified in seven out of 16 patients (44%).
• CT scanning demonstrated a higher sensitivity for visualizing this pattern compared to plain radiography.

Conclusions:

• The wedge-shaped pattern of increased attenuation on CT is a significant indicator of pulmonary infarction.
• CT imaging plays a crucial role in the diagnosis of pulmonary thromboembolism by revealing characteristic signs of infarction.
• The findings support the use of CT in the diagnostic workup of suspected pulmonary thromboembolism.