Close
How could you performed a diagnostic CTPA in this patient?
Inject contrast via a right arm IV cannula.
Non-diagnostic CTPA due to contrast passing from the IV cannula within the left arm through the left subclavian vein to the left superior vena cava. The left SVC drains into the left atrium.
There is communication between the left and right SVCs via a small vein anterior to the aorta (left brachiocephalic vein). The pulmonary trunk is non-opacified.
Arterial enhancing lesions adjacent to the left common carotid artery and within the body of the left adrenal gland represent known paragangliomas. There are also arterially-enhancing liver metastases.