Presentation
Chest pain. Previous DVT. ? PE.
Patient Data
Age: 50 years
Gender: Female
From the case:
Normal spectral CTPA
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There is satisfactory contrast opacification of the pulmonary tree. No filling defect in the main pulmonary trunk, bilateral pulmonary arteries or the major segmental branches to indicate PE. No perfusion abnormality on the Zeff.
The heart is normal. No pericardial effusion. No lymphadenopathy.
Dependent atelectasis in the bilateral lower lobes noted. No lung mass or nodule. No pleural effusion.
Upper abdominal organs imaged are unremarkable. Bones are unremarkable.
IMPRESSION
No pulmonary embolus.
Case Discussion
Case example of a normal spectral CTPA.
- the low monoenergetic (monoE, 45 keV) recons are used to provide an iodine boost to the pulmonary arteries, good if there is suboptimal contrast opacification.
- the Z effective (Zeff) recons provides a map of perfusion which details the presence of contrast in the lung, good to identify perfusion defects that may be due to subtle PEs.