MSCT angiography of the pulmonary artery:
Multiple non-enhancing filling defects are noted within the distal right main pulmonary, as well as the superior and inferior branches down to their 1st, 2nd and 3rd order branches, consistent with acute pulmonary thromboembolism.
The main pulmonary artery is patent, yet dilated up to 3.8 cm at its maximum diameter. The left main pulmonary and its branches are patent and homogeneously opacified. Mild cardiomegaly with concentric hypertrophy of the left ventricle. Mild atherosclerotic changes of the left anterior descending coronary artery is noted. No pleural or pericardial sac collection.
Incidental note of an enlarged left thyroid lobe with ~5 x 3 cm isodense lesion showing retrosternal extension abutting the superior mediastinal vessels and mildly deviating the trachea to the right side. Mild mediastinal lymphadenopathy. Bovine aortic arch with the left CCA arising in common origin with the brachiocephalic artery. The left vertebral artery arises directly from the aortic arch as well.
The scanned upper abdomen shows fatty hepatomegaly as well as mild splenomegaly and minimal perihepatic ascites.