Imaging includes X-ray, MRI, scintigraphy and ultrasound examinations.
There are no absolute contraindications for carrying out diagnostic procedures for non-invasive images except for MRI. The presence of metal objects inside the patient's eyes or brain precludes MRI.
The presence of a permanent pacemaker or internal defibrillator is a relative contraindication. In addition, gadolinium, when used as a contrast agent for MRI, increases the risk of systemic nephrogenic fibrosis in patients with chronic 4th or 5th stage kidney disease.
X-ray investigations used for chest imaging include chest X-ray, fluoroscopy, high resolution, and multilayer CT and angio-CT.
Chest x-ray examination and fluoroscopy are used to obtain images of the lungs and nearby anatomical structures. The chest radiograph provides images relating to internal and external structures in the chest and is very useful to identify any cardiac abnormalities, parenchymal lung, pleura, chest wall, diaphragm, mediastinal and lung ILI. Usually, it is the survey that is first done to study the lungs.
CT displays the intrathoracic structures and abnormalities more clearly than a standard chest x-ray can. Conventional (planar) CT provides multiple images of cross-sections of the chest, 10 mm thick. Its main advantage is the wide availability. The disadvantages are represented by the movement artifacts and by the limited resolution in the volume of fabric included in a 10 mm slice.
The spiral CT provides multiplanar images of the entire thorax acquired during apnea of 8-10 seconds while the patient is being moved in a continuous manner in the gantry of the CT. Spiral CT is considered at least equivalent to conventional CT for most applications. Before having a CT scan, it is recommended to know the CT scan cost in south Delhi. Its main advantages are speed, less exposure to radiation and the possibility of reconstructing the images on the 3 floors. The software can also generate images of the bronchial mucosa (virtual bronchoscopy).
MRI has a relatively limited role in lung imaging but is preferred over CT in specific circumstances (e.g., for the evaluation of neoplasms of the upper sulcus, possible cysts and indissociable lesions from the chest wall). In patients with suspicion of pulmonary embolism in whom IV contrast agents cannot be used, MRI can sometimes identify coarse proximal emboli, but normally its use is very limited in this pathology.
The advantages of MRI are the absence of radiation exposure for patients, the excellent visualization of vascular structures, the lack of bone artifacts and the excellent contrast of soft tissues.
Ultrasound is often used to facilitate certain procedures such as thoracentesis and the insertion of central venous catheters. Ultrasound is also very useful for assessing the presence and extent of pleural effusions and is now commonly used to guide thoracentesis to the patient's bed. Ultrasound performed on the patient's bed is becoming common to diagnose pneumothorax.
The biopsy endobronchial ultrasound-guided is increasingly being used in combination with fiber optic bronchoscopy to better locate masses and enlarged lymph nodes. The diagnostic yield of endo-bronchial ultrasound compared to conventional unguided techniques is higher as regards the transbronchial aspiration of the lymph nodes.