Presentation
COPD exacerbation and stroke with witnessed aspiration
Patient Data
1. The linear densities should not be in the lungs.
2. Some one can argue it is retained guidewire - less likely as it is very dense, discontinuous and when you window on CT it is tubular like a vessel.
Impression:
- Radiopaque linear density overlying the right hilum, concerning for cement embolization. Further evaluation with CT chest without contrast is recommended.
- Right upper lobe calcific density, which may represent a calcified granuloma or additional cement embolization.
- Thoracic vertebroplasty.
- Dense mitral valve annular calcification.
Two high density structures in the right upper lobe are likely cement, based on the cement in the paravertebral veins also. Cement leak into the paravertebral veins can lead to pulmonary cement embolism.
Axial MIP: cement in the lumbar veins
Case Discussion
This is likely chronic and nothing required acutely. Cement embolism is a well-known complication of vertebroplasty.