How would you report a limited CTPA when the team wants to discharge the patient?

Instruction: Give the impression and the immediate discussion, distinguishing what the scan excludes from what remains unresolved.

Context: A CTPA has good opacification of the main and lobar arteries, with no embolus there, but motion and poor distal enhancement make much of the segmental and subsegmental assessment nondiagnostic. The patient remains newly hypoxic and tachycardic. The emergency clinician asks whether “no PE” can be entered so discharge can proceed. A corrected repeat acquisition may be feasible after reviewing the technical failure.

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I would not call this a negative CTPA. My impression would be: “No central or lobar pulmonary embolus. Distal assessment is nondiagnostic because of motion and inadequate enhancement; pulmonary embolism is not excluded.”...

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