Neil Westermark was a 20th-century German radiologist who first discovered that a certain subset of patients diagnosed with pulmonary embolism (PE) were complicated by pulmonary infarction.⁶⁴ He described the “anemic” or oligemic peripheral regions of lung parenchyma as “wedge-shaped shadows.” Interestingly, he also found that the majority of patients with PE did not have pulmonary infarcts, a finding that has been affirmed in the more recent literature.⁴⁷ The chest radiograph (Fig. 24A) and CT (Fig. 24B) findings of increased translucency (chest radiograph) or hypoattenuation (CT) corresponding to oligemia in the periphery of the lung distal to an occlusive arterial embolus is typical.^3,4,64 Visualization typically signifies either occlusion of a larger lobar or segmental artery or widespread small vessel occlusion.^4,64

 

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