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Stroke is an important disease, because it is usually devastating and often fatal. Left atrial appendage (LAA) thrombi are well known as a cause for cerebral infarction, but pulmonary vein thrombi remain unknown. To detect LAA thrombi, transoesophageal echocardiography (TOE) is usually used. More recently, a 64-slice multidetector CT (64-MDCT) has proved to be an option for identifying them. The patient was 77-year-old male, and had a lacuna infarction in pons. A 64-MDCT demonstrated a 3 to 4 mm thrombus at the proximal side of right upper pulmonary vein. After 2 months warfarin therapy, the thrombus disappeared. When assessing the possible cause for cerebral infarction, it is important to identify thrombi within the LAA, and in the left pulmonary vein. 64-MDCT seems to be more suitable and reliable than TOE to detect thrombi of the pulmonary vein, because of no influence of pulmonary air.

A thrombus of the right upper pulmonary vein: detection by the use of a 64-MDCT