Evaluation of Lung Perfusion With Dual-Energy Computed Tomography in a Chronic Pulmonary Thromboembolism Patient

Abstract

A42-year-old man was admitted for dyspnea. He had a history of deep vein thrombosis and pulmonary embolism 10 years prior and had been followed-up since due to pulmonary hypertension caused by chronic pulmonary thromboembolism. A pulmonary computed tomography (CT) angiogram fused to a color-coded perfusion image using dualenergy CT demonstrated organized thrombi along the wall of the intrapericardial right main pulmonary artery (arrowheads, Fig 1), as well as multiple lobar and segmental branches. It showed generally reduced perfusion in the right upper lung and multisegmental perfusion defects in the left lung (Fig 1A) and both lower lobes (Fig 1B). The patient underwent pulmonary endarterectomy, and organized thrombi were removed. Echocardiography the next day revealed a decrease in right ventricular systolic pressure. A follow-up CT