The frequency of an incidental pleural effusion detected on an incomplete thoracic imaging study including neck, spine, and abdomen varies based on the indication and type of imaging modality, in the range of 1% to 5% [65-71]. The clinical significance of these incidental pleural effusions is variable. In a retrospective study of patients undergoing run-off CTA, 4.2% (9/214) had an incidental pleural effusion, leading to the diagnosis of pneumonia in 22% (2/9) and optimization of heart failure therapy in 44% (4/9) [72]. However, in a study of 352 patients undergoing MRA of the abdomen, pelvis, and lower extremities, 2.9% had an incidental pleural effusion, and no patients required follow-up diagnostic testing or change in therapy. CT Chest With IV Contrast There is no relevant literature to support the use of CT chest with IV contrast as the next imaging study following a pleural effusion incidentally detected on prior abdominal imaging. The recommendation for a follow-up CT chest with IV contrast should be based on clinical assessment (eg, clinical suspicion of malignancy). CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast as the next imaging study following a pleural effusion incidentally detected on prior abdominal imaging. The recommendation for a follow- up CT chest without and with IV contrast should be based on clinical assessment. CT Chest Without IV Contrast There is no relevant literature to support the use of CT chest without IV contrast as the next imaging study following a pleural effusion incidentally detected on prior abdominal imaging. The recommendation for a follow-up CT chest without IV contrast should be based on clinical assessment (eg, clinical suspicion of malignancy).
Workup of Pleural Effusion or Pleural Disease. The frequency of an incidental pleural effusion detected on an incomplete thoracic imaging study including neck, spine, and abdomen varies based on the indication and type of imaging modality, in the range of 1% to 5% [65-71]. The clinical significance of these incidental pleural effusions is variable. In a retrospective study of patients undergoing run-off CTA, 4.2% (9/214) had an incidental pleural effusion, leading to the diagnosis of pneumonia in 22% (2/9) and optimization of heart failure therapy in 44% (4/9) [72]. However, in a study of 352 patients undergoing MRA of the abdomen, pelvis, and lower extremities, 2.9% had an incidental pleural effusion, and no patients required follow-up diagnostic testing or change in therapy. CT Chest With IV Contrast There is no relevant literature to support the use of CT chest with IV contrast as the next imaging study following a pleural effusion incidentally detected on prior abdominal imaging. The recommendation for a follow-up CT chest with IV contrast should be based on clinical assessment (eg, clinical suspicion of malignancy). CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast as the next imaging study following a pleural effusion incidentally detected on prior abdominal imaging. The recommendation for a follow- up CT chest without and with IV contrast should be based on clinical assessment. CT Chest Without IV Contrast There is no relevant literature to support the use of CT chest without IV contrast as the next imaging study following a pleural effusion incidentally detected on prior abdominal imaging. The recommendation for a follow-up CT chest without IV contrast should be based on clinical assessment (eg, clinical suspicion of malignancy).