Clinical Information:
67-year-old male with shortness of breath and pleuritic chest pain. Rule out pulmonary embolism.

Technique:
CT pulmonary angiography with IV contrast was performed.

Findings:
There are filling defects within the right and left main pulmonary arteries extending into the lobar branches, compatible with bilateral pulmonary emboli. No evidence of right heart strain.

Ground glass opacities are present within the peripheral lungs bilaterally, suggesting a component of hemorrhage.

The main pulmonary arteries are dilated, with a diameter of 3.4 cm on the right and 3.1 cm on the left (upper limits of normal).

No pleural effusion is identified.

Impression:
1. Bilateral pulmonary emboli involving the right and left main pulmonary arteries and lobar branches.
2. Findings suggestive of pulmonary hemorrhage.
3. Pulmonary artery dilation suggesting chronic pulmonary hypertension.

Recommendation:
Clinical correlation is recommended. Anticoagulation therapy should be initiated if not already started. Consider echocardiography to evaluate for right heart strain.