The hyperdense lumen sign: the tale of the elusive pulmonary embolism

There are more well-recognised indirect signs of acute PE, which are neither sensitive nor specific, including pulmonary arterial dilation, pleural effusion, regional oligaemia, subpleural pulmonary consolidations and/or airspace opacities. 1 In our case, the patient had a dilated main pulmonary artery ( figure 2 ), suggestive of pulmonary hypertension and evidence of right heart strain with cor pulmonale confirmed on echocardiogram.