Unusual Presentations of Pulmonary Embolism on CT Pulmonary Angiography (CTPA)
DOI:
https://doi.org/10.69980/ajpr.v28i4.242Keywords:
CT Pulmonary Angiography (CTPA), pulmonary embolism (PE), retrospective analysis, life-threatening conditionAbstract
Computed Tomography Pulmonary Angiography (CTPA) is the gold standard for diagnosing the life-threatening condition, pulmonary embolism (PE), and therapy is needed as quickly as possible. Its radiological appearance, however, can occasionally be different from classic patterns and therefore be a subject for a diagnostic challenge. This study aims to characterize atypical presentations of PE on CTPA, focusing on unique interpretative difficulties. Retrospective analysis was performed on 5 patients with confirmed PE, in whom there were unusual CTPA findings in all patients. PE mimicking pneumonia, mass-like pulmonary infarction, saddle embolism without right heart strain, isolated subsegmental embolism with minimal symptoms, and tumour embolism from renal cell carcinoma were included in the cases. Initial diagnoses were postponed in three cases due to misleading thoracic imaging appearances resembling other thorax lesions. Accurate diagnoses require a thorough correlation with clinical data and re-evaluation of CTPA images. Findings underscored the need for a continued high index of suspicion for the rare cases and integration of clinical context with imaging to distinguish the image from other pathologies. Therefore, the radiologists must be vigilant and use advanced imaging techniques to aid timely and effective management of PE. The present case series illustrates the necessity for additional education in the radiologic examination of pulmonary embolism.
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