Imaging of acute pulmonary embolism: an update
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On the PA chest-film it is important to examine all the areas where the lung borders the diaphragm, the heart and other mediastinal structures. These lines and silhouettes are useful localizers of disease, because they can be displaced or obscured with loss of the normal silhouette. This is called the silhouette sign , which we will discuss later. The paraspinal line may be displaced by a paravertebral abscess, hemorrhage due to a fracture or extravertebral extension of a neoplasm. Displacement of the para-aortic line can be due to elongation of the aorta, aneurysm, dissection and rupture. The anterior and posterior junction lines are formed where the upper lobes join anteriorly and posteriorly.