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Thrombolytic therapy is a quick, simple and effective method for the treatment of acute venous thromboembolic disease.1 Currently, it is being used to treat patients with thromboembolism which appeared within two weeks.2 However, the pathophysiologic of process of the disease shows great differences in individuals.3 If imaging techniques could be used to evaluate pathophysiologic stage of the thrombus, physicians would be able to choose the therapeutic window more reasonably. Four cases of venous thromboembolic disease are discussed attempting to find diagnostic evidence of acute thrombosis on CT images and establish thrombolytic therapy by using CT pulmonary angiography (CTPA) and indirect CT venography (CTV).