ct scan result ..need help

[onlinejames]

i went for a ct scan because of shortness of breath and previous history of a dvt in my leg 18 months ago, im 41male
previous DVT, increasing exertional dyspnoea

the conclusion was
no central pulmonary embolus.
heterogeneous contrast opacification within the segmental pulmonary arteries raises the possibilty of non-occlusive thromboembolus

what does all this mean

[onlinejames]

i was told 6 to 9 months
thank you for very much for your help doctor Gary

[Garry Choy, MD, MS]

Yes given your symptoms of shortness of breath and chest pain (if no other reason is found) then these small clots may be causing your symptoms -- an entirely reasonable course of treatment with anti-coagulation.  How long are you going to be on warfarin?  

[onlinejames]

Thank you for your reply
I have been put on Clexane and warfarin for this
Is it posible that this finding be causing loss of breath and chest discomfort ( pain ), if it isnt very significant why did they put me on clexane and warfarin
The only other problem i have is a cuspid aortic heart valve with mild stenosis and mild to moderate regurgitation , i dont smoke either
b.p has been high ( 180/105 ), now 140 over 70 with meds, chol was 8.2. now 7.1 with meds
thanks for your responses

[Garry Choy, MD, MS]

Excellent question.  Many radiology reports have a lot of technical jargon unfortunately.  

What that means is that:
1) you can rest assured there is no large pulmonary embolus (clot) that will block your pulmonary arteries; "central" pulmonary emboli are clots that sit in the large branches of pulmonary arteries and these can be life threatening and cause severe symptoms.  

2) "heterogeneous contrast opacification within segmental pulmonary arteries" that "raises the possibility" of "non-occlusive thromboembolus" means that it is hard to definitively tell if there is truly an obstructive clot in the small pulmonary arteries.  CT scans are very good at picking up pulmonary emboli in larger vessels but often times, "segmental" pulmonary arteries (the small ones) are difficult to evaluate.  Fortunately, even if there are small clots in segmental pulmonary arteries, they are usually (statistically) not clinically significant in patients who have good pulmonary reserve and otherwise healthy.

I recommend you also talk to your doctor about the final interpretation of the radiology report as he knows your history and has seen the images/more details of the report.

Best wishes,
GC