The hyperdense lumen sign: the tale of the elusive pulmonary embolism

Okechukwu, Nancy; Curran-Melendez, Sheilah M.; Weyer, Allison; Mickus, Timothy

doi:10.1136/bcr-2014-205986

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…A thrombus in the pulmonary trunk or main PA is a life-threatening disease, and a prompt diagnosis is critical for a favorable outcome. Recent reports have shown that several signs of PTE have been observed via unenhanced CT, including a hyperdense lumen sign, PA dilatation, and wedgeshaped consolidation [3][4][5][6][7][8][9] . Among these signs, the hyperdense lumen has a high diagnostic performance, but it only occurs in 50-70% of cases 8,9) .…”

Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation of the Attenuation Value of Pulmonary Thrombus on Unenhanced Computed Tomography

Ichinose

Nomura

Okada

et al. 2021

Juntendo Medical Journal

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Objective: To identify pulmonary thromboembolism (PTE) using the thrombus attenuation value on unenhanced computed tomography (CT).Design: Single-center retrospective study (January 2015-Marcg 2020). Methods:Patients who underwent both unenhanced and enhanced CT for suspected PTE were enrolled. Patients with a hyperdense lumen on unenhanced CT and thrombi in the peripheral pulmonary artery (PA) were excluded. Patients were classified into two groups: thrombi (thrombi detected in PA by enhanced CT) and non-thrombi (attenuations of the main PA evaluated as thrombi). Mean CT attenuation values of the thrombi, main PA, and pulmonary trunk (blood pool) were measured.The attenuation values of the thrombus (T) and the thrombus to blood-pool (T/P), thrombus to hemoglobin (T/Hb), and thrombus to hematocrit (T/Ht) ratios were evaluated. The cut-off attenuation value of the thrombus was calculated by a receiver operating characteristic curve and its accuracy in detecting PTE was determined.Results: Of the 260 patients enrolled, 40 were included, of whom 24 had confirmed PTE. The mean T was 27.25 Hounsfield units(HU) and 36.66HU (p<0.001), and the T/P ratio was 0.74 and 0.99 (p=0.004) in the PTE and non-PTE groups, respectively.The thrombus cut-off value for PTE diagnosis was 30.85 HU. The sensitivity and specificity were 79. 9% and 87.5%. Conclusions:Measuring and evaluating the attenuation value for the central PA and T/P ratio on unenhanced CT improves the diagnostic ability of central PTE in patients suspected to have PTE but cannot tolerate contrast medium.

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Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation of the Attenuation Value of Pulmonary Thrombus on Unenhanced Computed Tomography

Ichinose

Nomura

Okada

et al. 2021

Juntendo Medical Journal

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“…PE can also be detected on conventional CT chest with, and sometimes even without, intravenous contrast administration. Occasionally, PE can be detected on noncontrast CT as the “hyperdense lumen sign”, which results from hyperdensity of the acute thrombus, secondary to increased concentration of hemoglobin [5].…”

Section: Discussionmentioning

confidence: 99%

“Distal bright vessel sign” – Novel radiological sign of pulmonary thromboembolism

Semionov

Kosiuk

2020

Radiology Case Reports

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We describe a novel radiological sign of pulmonary thromboembolism on computed tomography aortic angiogram. It consists of focal hyperenhancement of pulmonary arteries distal to the pulmonary thrombus, while the thrombus itself remains occult and the rest of pulmonary arteries are hypoattenuating. The sign was observed on computed tomography aortic angiograms in 2 patients assessed for suspected acute aortic syndrome. Pulmonary emboli were subsequently confirmed with computed tomography pulmonary angiography.

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Saddle pulmonary embolism on non-contrast CT

Chaudhry¹,

Alekseyev²,

Didenko³

et al. 2021

JLPRR

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Background: A saddle pulmonary embolism (PE) is a large embolism that straddles the bifurcation of the pulmonary trunk. This PE extends into the right and left pulmonary arteries. There is a greater incidence in males. Common features of a PE include dyspnea, tachypnea, cough, hemoptysis, pleuritic chest pain, tachycardia, hypotension, jugular venous distension, and severe cases Kussmaul sign. The Wells criteria for PE is used as the pretest probability. Diagnostics include D-dimer levels, CT pulmonary angiography (CTPA), ventilation/perfusion scintigraphy (V/Q scan), echocardiography, lower extremity venous ultrasound, chest x-ray, pulmonary angiography, and electrocardiography (ECG). Case description: We present a 65-year-old male that presented with a two-week history of dyspnea with non-radiating intermittent chest pressure. Initial V/Q scan showed a low probability for PE, but a subsequent non-contrast CT revealed that he indeed had a saddle PE.

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The hyperdense lumen sign: the tale of the elusive pulmonary embolism

Cited by 3 publications

References 3 publications

Quantitative Evaluation of the Attenuation Value of Pulmonary Thrombus on Unenhanced Computed Tomography

Quantitative Evaluation of the Attenuation Value of Pulmonary Thrombus on Unenhanced Computed Tomography

“Distal bright vessel sign” – Novel radiological sign of pulmonary thromboembolism

Saddle pulmonary embolism on non-contrast CT

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