Fig. 1&2: Axial CT image shows a partial thrombus (stars) in the main and proximal left pulmonary artery that forms an obtuse angle with the vessel wall. There is enlarged pulmonary artery and bronchial collaterals (arrows).
- Some pulmonary emboli do not resolve and form endothelialized fibrosis of pulmonary vascular bed, thought to be due to disturbance in thrombus resolution
- Results: pulmonary HT, cor pulmonale, bronchial hypertrophy
- Multiple episodes of PE
- Younger age
- Larger perfusion defect
- Idiopathic cause of PE
- Complete thrombus with small vascular diameter
- Partial crescent-shaped, eccentric thrombus
- Calcified thrombus
- Web, band
- Pulmonary hypertension
- Collaterals from bronchial arteries
- Mosaic attenuation of the lungs
Castaner E, et al. CT diagnosis of chronic pulmonary thromboembolism. Radiographics 2009;29:31-50.