Presentation
Sudden hypotension at time of prostatic biopsy, no bleeding. Pulmonary hypertension on echocardiogram
Patient Data
Inadequate technique missing the contrast bolus ie contrast predominately in the left side of the circulation missing the pulmonary circulation
CT examination repeated on same day with earlier initiation of the image acquisition.
Once the contrast bolus is "caught" in the pulmonary circulation, the examination is normal ie no PE
Case Discussion
IN CTPA, the mean HU density of contrast must be > 250 in the pulmonary outflow tract in order to avoid the possibility of flow-related artefacts in the pulmonary artery branches