Pediatric Pulmonary Embolism

  • Etiology: usually arises from migration of deep venous thrombosis into the pulmonary artery, hypercoagulable states such as use of oral contraceptives are a risk factor
  • CXR: peripheral wedge-shaped opacity (Hampton’s hump)
  • V/Q: Normal ventilation with lack of perfusion (V/Q mismatch)
  • CT: intraluminal filling defects in the pulmonary artery which if large enough may result in peripheral pleural-based wedge shaped opacities, more common in lower lobes than upper lobes
  • Clinical: risk factors are central line / dehydration / sepsis / malignancy / renal disease / surgery / trauma

Radiology Cases of Pulmonary Embolism

CXR, VQ scan, angiogram of pulmonary embolism / pulmonary embolus / PE
CXR AP (above) shows a large wedge shaped infiltrate in the right lower lobe and a right pleural effusion. Ventilation image from a V/Q scan (middle left) shows normal ventilation to both lungs. Perfusion image from a V/Q scan (middle right) shows essentially no perfusion to the right lung. PA image from a pulmonary angiogram shows a near complete lack of blood flow to the right lung.