64-MDCT Scan Demonstrated Pulmonary Vein Thrombus

Hidekazu Takeuchi

doi:10.4172/2155-9562.s8-002

Abstract

Although the relationship between deep venous thrombosis and pulmonary embolism is well known and studied extensively, the relationship between pulmonary vein thrombus (PVT) and systemic embolism such as cerebral infarction is unknown. 64-slice multidetector computed tomography (64-MDCT) scan can demonstrate PVT. We had reported two cases of small thrombus within the right upper pulmonary vein and the left upper pulmonary vein. A 74-year-old male with chronic atrial fibrillation was referred to be examined cardiac thrombus. 64-MDCT scan demonstrated large thrombi, which expanded from the right upper pulmonary vein to the left upper pulmonary vein and the left atrium. Three months warfarin therapy decreased the size of thrombi and changed the shape of thrombi. PVT is potentially life threatening condition and is thought to be a rare, but PVT seems to have been significantly underestimated. The 64-MDCT scan can assess PVT effectively and completely.

Highlights

Stroke is an important clinical problem of serious long-term disability and death, which is associated with significant morbidity, mortality, and socioeconomic impact. 20-25% of ischemic stroke is caused by immobilization of cardiogenic thrombi [1]
In 2012, for the first time, we reported two cases of small thrombus in the right upper pulmonary vein [11] or in the left upper pulmonary vein [12] in the patients without lung surgery or catheter ablation by using 64-slice multidetector computed tomography (64-MDCT)
We have identified large thrombi, which expand from the right upper pulmonary vein to the left upper pulmonary vein and left atrium (LA) in one Atrial fibrillation (AF) patient without lung surgery or catheter ablation by 64-MDCT scan

Summary

Introduction

Stroke is an important clinical problem of serious long-term disability and death, which is associated with significant morbidity, mortality, and socioeconomic impact. 20-25% of ischemic stroke is caused by immobilization of cardiogenic thrombi [1]. In 2012, for the first time, we reported two cases of small thrombus in the right upper pulmonary vein [11] or in the left upper pulmonary vein [12] in the patients without lung surgery or catheter ablation by using 64-MDCT. We have identified large thrombi, which expand from the right upper pulmonary vein to the left upper pulmonary vein and left atrium (LA) in one AF patient without lung surgery or catheter ablation by 64-MDCT scan. Large thrombi in the right upper pulmonary vein, the left upper pulmonary vein and LA were detected in axial (Figure 1a) and sagittal (Figure 2a) images as the defect of an enhancement by 64-MDCT scan. The present patient had no proof of lung cancer in the chest roentgenogram, in the 64-MDCT’s images of both sides of middle to lower lung and in clinical symptoms

Discussion

Conclusion