264Lu Chronic Pulmonary Embolism with String Like Changes of the Middle Lobe Arteries CTPA Pulmonary Embolus 15 Years Ago CTPA Pulmonary Embolus 15 Years AgoCTPA 15 years ago shows a large thrombotic embolus in the right main pulmonary artery extending into the middle lobe arteryAshley Davidoff MD TheCommonVein.net 136172 CTPA Pulmonary Embolus 15 Years Later Obstructive Dystrophic Calcification CTPA Pulmonary Embolus 15 Years Later Obstructive Dystrophic CalcificationCTPA 15 years following an acute pulmonary embolus reveals an obstructive dystrophic calcification at the origin of the middle lobe pulmonary artery (b ringed in white). There is a suggestion of paucity of contrast in the middle love Ashley Davidoff MD TheCommonVein.net 136173cL Pulmonary Embolus 15 Years Later Obstructive Dystrophic Calcification Attenuated Middle Lobe Artery CTPA Pulmonary Embolus 15 Years Later Obstructive Dystrophic Calcification Attenuated Middle Lobe ArteryCTPA 15 years following an acute pulmonary embolus, reveals an obstructive dystrophic calcification at the origin of the middle lobe pulmonary artery (a, green arrowhead) The middle lobe arteries distal to the calcification are attenuated due to proximal obstruction (a, red arrowhead and b red ring) . The normal sized arteries are shown in images ringed in images c, d and e demonstrating the normal ratio of arterial to bronchiole size. There is only mild scarring and ground glass change in the middle despite the apparent decrease in size of the artery.Ashley Davidoff MD TheCommonVein.net 136175cL01