Deep Vein Thrombophlebitis

Gross figure showing a pulmonary artery distended with an endoluminal thromboembolus.

FIGURE 1.3. Ventilation-perfusion imaging in diagnosis of pulmonary embolism. A:Ventilation image, obtained with 99mTc pentetate aerosol, shows homogenous ventilation on posterior view. B: Matched perfusion image shows large (segmental) perfusion defects in the left mid lung, and in the lateral segment of the left lower lobe. There is also decreased perfusion in the right upper lobe. The presence of unmatched segmental abnormalities indicates a high probability for pulmonary embolism.

FIGURE 36.2. Bilateral pulmonary embolism (arrows) demonstrated by contrast-enhanced spiral computed tomography scan.

FIGURE 36.4. A magnetic resonance image reveals extensive thrombosis in the left iliac system (arrow) extending into the inferior vena cava (arrowhead).

<bold>Figure 13.5</bold> Contrast enhanced multirow (16-slice) detector chest CT in a patient with acute pulmonary embolism. In the coronal reconstructed view, multiple segmental emboli can be visualized <italic>(arrows)</bold>. (Figure kindly provided by Joseph Schoepf, MD, Department of Radiology, Brigham and Women’s Hospital, Boston, MA.)

<bold>Figure 13.7</bold> Primary evidence of acute pulmonary embolism. Selective cut-film angiogram of the right lower lobe pulmonary artery with multiple intraluminal radiolucencies, almost completely outlined by contrast <bold>(left)</bold>. Corresponding segmental perfusion defects of the right lower lobe <bold>(right)</bold>.

<bold>Fig C 1-22 Pulmonary infarction.</bold> (A) Chest film made 3 days after open-heart surgery demonstrates a very irregular opacity at the right base (pneumonia versus pulmonary embolization with infarction). (B) On a film made 5 days later, the consolidation is seen to have reduced in size yet to have retained the same general configuration as on the initial view. The diagnosis of pulmonary embolism was confirmed by a radionuclide lung scan.⁵

Figure 16-55 <bold>IVC UMBRELLA FILTER. A. AP Lumbar. B. Lateral Lumbar.</bold> This metallic umbrella fillter is placed in the inferior vena cava to capture emboli from the lower extremities in patients with thrombophlebitis.

Figure 18-110<bold>DEEP VENOUS THROMBOSIS. A. Ultrasound,Lower Limb.</bold>Note the thrombus within the femoral vein (<italic>arrows</bold>). Failure of the vein to collapse from the compression of the ultra sound head confirms the presence of endoluminal thrombus (<italic>arrowheads</bold>). <bold>B. Pulmonary Embolism,Pulmonary CT Angiogram, Axial Chest.</bold>Observe the emboliin the pulmonary artery (<italic>arrow</bold>) and left atrium (<italic>arrow</bold>). <bold><italic>COMMENT:</bold></bold>Lower limb ultrasound evaluation is routinely p...

<bold>FIGURE 24-15</bold> Common sites of venous thrombosis. (<bold>A</bold>) Superficial thrombophlebitis. (<bold>B</bold>) Most common form of deep thrombophlebitis. (<bold>C</bold> and <bold>D</bold>) Deep thrombophlebitis from the calf to iliac veins.

Venous thrombosis. The femoral vein has been opened to reveal a large thrombus within the lumen.

Filling defect consistent with thrombus in the left atrial appendage in a patient in atrial fibrillation.

Echocardiography in a patient with massive pulmonary embolism. The right ventricle (RV) is markedly enlarged, flattening the intraventricular septum and compromising the left ventricle (LV).

<bold><italic>Figure 13.28.</bold></bold> Measurement of the lower extremity circumference. Increase in size is consistent with swelling, which might be due to a deep venous thrombosis.

<bold>Figure 1.25. Ventilation-perfusion scan in a patient with pulmonary emboli. A.</bold> Perfusion scan of the lungs shows many areas devoid of radioisotope (photopenia) bilaterally. <bold>B.</bold> The ventilation scan is normal. This combination of findings is diagnostic of pulmonary embolism.

Schematic of development of thrombus in deep vein

<bold>FIGURE 10-18. Coronary artery thrombosis.</bold> A microscopic section of a coronary artery shows severe atherosclerosis and a recent thrombus in the narrowed lumen.