Multi-slice spiral CT diagnosis of septic pulmonary embolism

Objective: To study the multi-slice spiral CT (MSCT) manifestations of septic pulmonary embolism(SPE) in order to get a better understanding of the disease. Methods: The MSCT manifestations of 12 patients with septic pulmonary embolism were retrospectively analyzed and compared with chest radiograph. Results: Of the 12 patients, Chest radiograph and CT scanning showed multiple peripheral pulmonary nodules in 8 and 12 cases, a feeding vessel sign(0, 9 cases), cavitations(6,10 cases) and wedge-shaped opacities(4,7 cases), focal infiltrates(2,4 cases), air cyst(2,5 cases), pleural lesions (3,6 cases), hilar or mediastinal lymphadenopathy (0,3 cases). Peripheral or subpleural zones were most commonly affected (8,12 cases). CT was more useful in revealing nodules and a feeding vessel sign. Multiplanar reconstructions (MPR), maximum intensity projection (MIP) showed that most of these vessels passed around nodules and wedge-shaped lesions. MPR showed regular nodular margin. Conclusion: SPE presents with variable and often nonspecific clinical and radiographic features. MPR and MIP showed the features of nodules and feeding vessels better. The diagnosis is usually suggested by the presence of a predisposing factor, febrile illness, and CT findings of multiple, periphery pulmonary nodules, with or without cavitation and a feeding vessel sign. (authors)