The use of multi-detector computed tomography and ultrasonography for evaluation of pleural lesions

Background and objectiveMultidetector CT (MDCT) and ultrasonography (US) are of increasing importance for assessment of many pulmonary disorders. Our aim was to evaluate their role in diagnosis of pleural diseases.MethodsPatients from Tanta University Hospital who were suspected to have pleural lesions (symptoms, signs and/or suggestive chest X-ray) during one year period were enrolled in the study. US and MDCT were done for all of them, then data were reported and analyzed.ResultsSeventy-one patients were included, sixty of them had evident pleural lesions. Chest pain was the commonest presenting symptom. Malignancy represented 36.7% of pleural lesions, a percentage similar to lesions due to infection etiology. Free pleural effusions were the most common pleural lesions followed by pleural thickening. US was diagnostic in 72% of pleural lesions detectable by MDCT. Multiplanar reconstruction (MPR) images had an additional value than axial images in 39% of pleural lesions, mostly in cases of pleural thickening, free pleural effusion, pleural masses, encysted pleural effusions and pleural plaques. On the other hand, the MPR images had the same value as axial images in empyema and pneumothorax cases.ConclusionMDCT is an important noninvasive imaging tool in accurate detection and characterization of pleural lesions with complementary MPR images that solve many diagnostic problems. Ultrasonography is a safer alternative but with less diagnostic value.