CT
Axial C+ CTPA
Axial C+ CTPA windowed
Axial low monoE
Axial thick MIP
Axial lung window
Axial Z effective
Coronal C+ CTPA
Sagittal C+ CTPA
The scan is of good diagnostic quality. Pulmonary embolus at the origin of the left lower lobar pulmonary artery extending into its segmental branches, with associated reduced perfusion on the spectral images. Further occlusive emboli in the medial segment of the right middle lobe and a subsegmental artery in the posterior segment of the right upper lobe, again with perfusion changes on the spectral images. Non-occlusive embolus in the right lower lobe. No CT evidence of right ventricular strain. RV/LV ratio is 0.9 (normal is <1.0). The heart and mediastinal structures are normal.
Patchy ground glass change in the left lower lobe, most confluent in the left costophrenic angle, which may represent developing changes of infarct in this setting. No pneumothorax. Small left pleural effusion
The upper abdominal viscera are unremarkable. No mass in the lower neck. Bones and soft tissues are normal.
IMPRESSION
Study positive for PE, with large embolism at the origin of the left lower lobe pulmonary artery extending distally, and smaller emboli in the right lung.