Case Review: X-ray & CT of Pulmonary Infarction - a podcast by Daniel J. Kowal, MD

In this radiology lecture, we discuss the chest x-ray and CT appearance of pulmonary infarction in the setting of acute pulmonary embolism.

Key points include:



* Uncommon complication of pulmonary embolism.

* Most common in right lung.

* Risk of infarction increases with large clot burden.

* Typically wedge-shaped, peripheral consolidation with no air bronchograms (Hampton hump).

* However, may not be wedge-shaped, and not all wedge-shaped opacities will be infarcts in the setting of pulmonary embolism.

* “Bubbly” consolidation containing rounded, central lucencies: Most specific finding of infarct* and represents a combination of infarcted, necrotic lung and adjacent viable, aerated lung.

* “Vessel” sign: Enlarged vessel leading to apex of a wedge-shaped opacity. Vessel is dilated due to the presence of intraluminal thrombus or distal obstruction.



*Revel MP, Triki R, Chatellier G, et al. Is it possible to recognize pulmonary infarction on multisection CT images? Radiology. 2007;244(3):875-882.

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