MRI can help distinguish components of complex fluid collections, including septations [80], and is thought to be slightly better at distinguishing benign from malignant pleural thickening [81]. Improved soft-tissue contrast allows for better demonstration of soft-tissue relationships, which can facilitate the assessment of invasion and neurovascular encasement. Small studies have shown that MRI is capable of providing diagnostic images to guide surgical chest wall reconstruction [82]. There is extensive supportive literature in pediatric populations surrounding the detection and management of pectus excavatum. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT remains a secondary test that may be used in the staging of mesothelioma and pleural metastatic disease. Chronic Dyspnea-Noncardiovascular Origin US Chest US can complement the imaging evaluation of several abnormalities. US has an established role in pleural effusion, including detection, differentiation from lung disease, characterization, and guidance of intervention. US may be more efficacious than chest radiography and CT at detecting internal septations in complex pleural effusions [83]. Pleural thickening, plaques, and masses may be identifiable on US, although US is not recommended in their workup. US is advantageous in the bedside diagnosis of pneumothorax and is most often used in acute assessment [84]. Variant 6: Chronic dyspnea. Suspected diaphragm dysfunction. Initial imaging. Radiography Chest A static chest radiograph is useful to assess the relative position of the diaphragm and its effect on lung volumes and can provide clues to diaphragm paralysis compared to a fluoroscopic reference standard [85]. Fluoroscopy Chest With fluoroscopic visualization, more accurate assessment of diaphragmatic motion can be made [86,87].
Chronic Dyspnea Noncardiovascular Origin. MRI can help distinguish components of complex fluid collections, including septations [80], and is thought to be slightly better at distinguishing benign from malignant pleural thickening [81]. Improved soft-tissue contrast allows for better demonstration of soft-tissue relationships, which can facilitate the assessment of invasion and neurovascular encasement. Small studies have shown that MRI is capable of providing diagnostic images to guide surgical chest wall reconstruction [82]. There is extensive supportive literature in pediatric populations surrounding the detection and management of pectus excavatum. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT remains a secondary test that may be used in the staging of mesothelioma and pleural metastatic disease. Chronic Dyspnea-Noncardiovascular Origin US Chest US can complement the imaging evaluation of several abnormalities. US has an established role in pleural effusion, including detection, differentiation from lung disease, characterization, and guidance of intervention. US may be more efficacious than chest radiography and CT at detecting internal septations in complex pleural effusions [83]. Pleural thickening, plaques, and masses may be identifiable on US, although US is not recommended in their workup. US is advantageous in the bedside diagnosis of pneumothorax and is most often used in acute assessment [84]. Variant 6: Chronic dyspnea. Suspected diaphragm dysfunction. Initial imaging. Radiography Chest A static chest radiograph is useful to assess the relative position of the diaphragm and its effect on lung volumes and can provide clues to diaphragm paralysis compared to a fluoroscopic reference standard [85]. Fluoroscopy Chest With fluoroscopic visualization, more accurate assessment of diaphragmatic motion can be made [86,87].