CXR AP (above left) shows dextrocardia and an infiltrate in the left lower lobe. Anterior ventilation image from a V/Q scan (above middle) shows near-normal ventilation to the lungs. Posterior perfusion image from a V/Q scan (above left) shows markedly decreased perfusion to the left lung, with 95% of the perfusion going to the right lung. Coronal CT with contrast of the chest (below left) shows a massively enlarged left pulmonary artery with thrombus in its left lower lobe branches. Axial images (below middle and below right) show multiple peripheral infarcts in the left lower lobe.
The diagnosis was massive pulmonary embolism in the left pulmonary artery.
Pediatric Imaging 