False positive pulmonary embolus - CTPA

Case contributed by Dr Chris O'Donnell

Presentation

Sudden hypotension at time of prostatic biopsy, no bleeding. Pulmonary hypertension on echocardiogram

Patient Data

Age: 75
Gender: Male
CT

Routine CTPA

Inadequate technique missing the contrast bolus ie contrast predominately in the left side of the circulation missing the pulmonary circulation

CT

Repeat CTPA

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

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Case information

rID: 16701
Case created: 12th Feb 2012
Last edited: 21st Sep 2015
System: Chest
Inclusion in quiz mode: Included

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