Pulmonary Embolism Caused by Acrylic Cement: A Rare Complication of Percutaneous Vertebroplasty

Chest radiograph and CT of 41-year-old woman with LCH after percutaneous vertebroplasty.

A, Chest radiograph shows pleural-based consolidation in the middle-lobe (arrow-head). Multiple high-density tubular opacities outlining pulmonary vessels (white arrows). Note a right pleural effusion (black arrow).

B, Chest CT scan at the level of bronchus intermedius shows characteristic appearance of pulmonary infarct in the middle lobe and pleural-based truncated cone consolidation (white arrow) between major and minor fissures.

C, Chest CT scan with soft tissue window settings. High-density intra-luminal cement (arrow) outlining the pulmonary artery and its bifurcation.

D, CT scan with bone settings at the level of vertebroplasty (L3) shows cement in right latero-vertebral vein draining in the vena cava (arrows).

E, Follow-up chest CT 1 month after vertebroplasty. Comparison with fig. 1B shows partial resolution of the pulmonary infarct in the middle lobe and persistence of cement in pulmonary artery (arrow).