CT
Axial C+ CTPA
Axial lung window
Coronal C+ CTPA
Coronal lung window
Saddle pulmonary embolus is present, with extensive occlusive thrombus in the distal right pulmonary artery, extending into lobar, segmental, and subsegmental branches of the right upper, right middle and right lower lobes. Thrombus is also in the lobar, segmental and subsegmental branches of the left lower lobe, and the segmental and subsegmental branches of the left upper lobe and lingula.
The main pulmonary artery diameter is in the upper limits of normal, however, there is bowing of the interventricular septum, and enlargement of the right ventricle suggesting right ventricular strain.
An ovoid region of consolidation is in the right posterior costophrenic angle, which may reflect a Hampton’s hump/areas of ischaemic lung. Minor bibasal atelectasis.