 Welcome everyone, I am Yashastani Basupoena, junior resident of department of radio diagnosis, studying in KSAG Medical Academy and I'm here to present my paper on the topic of CT pulmonary angiography and well score evaluation of pulmonary embolism. Coming to the aim of the study, it is to correlate pulmonary angiography findings with well score in predicting the pulmonary embolism. Pulmonary embolism is the third leading cause of cardiovascular related deaths with the prevalence of pulmonary embolism in the hospitalized individuals is 15 to 26%. Phenically the patients might present with dyspnea, chest pain, syncope, shock or hypertension and the clinical diagnosis is difficult. And there is a wealth criteria which helps us to assess the risk stratification based on the clinical symptoms in patients probably with acute pulmonary embolism and for which history and examination is necessary. Diagnosis of pulmonary embolism includes ventilation, perfusion scanning, contrast enhanced CT arteriography, MR imaging and standard pulmonary arteriography. The multi detector CT arteriography is the immediate modality of the choice and has the highest sensitivity and specificity for detecting embola in the main, low bar and segmental pulmonary arteries. In addition, this can also detect pulmonary arterial hypertension and abnormalities of perfusion as well. Methods, we have conducted a retrospective study on 41 patients who had clinical suspicion of pulmonary embolism and all the patients had CT pulmonary angiography done in KSI Medical Academy. Coming to the CT protocol, it was done in GE revolution, evolution machine 128 slice and plane and RTDL phase was done with 1.2 mm angiosection taken through a Pisces of the lung to the lower part of the liver and multi planar reformats were obtained. MIP and VR images were also obtained for pulmonary artery and iota. Coming to well score, based on the clinical features, all the patients were assigned well score and were classified into low, intermediate and high risk. Low risk was a patient with 0 to 2 points, intermediate was a patient with 3 to 6 points and high risk is more than 6 points. Coming to the results, among the total patients, 39 patients had a high clinical suspicion of CT pulmonary angiography and 2 were having less clinical suspicion of CT pulmonary embolism. The age group of the patients who had clinical features were ranging from 25 to 78 years and the frequency of pulmonary angiography in pulmonary embolism in our study was 25 people had pulmonary embolism which was corresponding to 61% while 16 patients did not have embolism which was corresponding to 39%. Out of these patients who had pulmonary embolism, 15 patients were male and 60% of them were male and 40% were females. Among the patients who had pulmonary embolism, 56% of the patients had acute embolism and 44% of the patients had chronic embolism. Here, we can see a 54-year-old male patient who had presented with history of DVT whose CT axial images show a chronic thrombus noted in the left intolobar artery. Coming to the second image, there is a 53-year-old female who presented with sudden onset of breathlessness whose CT axial images show an eccentric thrombus which is seen in the right and left pulmonary arteries and this thrombus has seen extending into the segmental arteries as well. Coming to the correlation with the well score, the well score was given as three. Three patients had a well score of low risk, 18 patients had the well score of intermediate or high risk and 20 patients had high risk. On CT pulmonary and joe, the patients who had low risk did not have any embolism whereas among the 18 patients, 50% of the patients with intermediate risk had pulmonary embolism and among 20% of the patients, 15 patients had embolism and high risk category. The most common clinical presentation was disney or breathlessness which was seen in 30 patients out of 44 amongst which 73% of the patients had embolism. 14 patients in our study had deep vein thrombosis or had a previous history of DVT but of which only 9 patients had embolism. Coming to DVT and its correlation with pulmonary embolism, patients who had DVT and having pulmonary embolism was 36% of the patients and 64% of the patients who had pulmonary embolism did not have DVT. Based on the location, the most common site for embolism in our study was the segmental arteries followed by right and left pulmonary arteries. 58% of the patients had thrombosis in the segmental arteries. Also multiple central segmental and subsegmental arteries were seen in 12% of the patients. Coming to the secondary features or other associated features which were observed in our study in patients who had embolism was right ventricular hypertrophy, mosaic attenuation, pulmonary arterial hypertension and pleural effusion. Among which 65% of the patients with pulmonary embolism had right ventricular hypertrophy and pulmonary arterial hypertension. Coming to the imaging findings of CTP, pulmonary embolism or CTPA in our study where one was poloment sign. Poloment sign is nothing but a central filling defect with peripheral contrast yielding a poloment sign. These are the images showing the poloment sign. Coming to the second image on the left side, there is a 64-year-old male who had a clinical suspicion of pulmonary embolism. Most CT axial images show a central filling defect with peripheral contrast in the upper left segmental artery giving to the poloment appearance.