Imaging

Lung Abscess

Preliminary Diagnosis: Lung Abscess

I. What imaging technique is first-line for this diagnosis

  • Chest x-ray, PA and lateral view

II. Describe the advantages and disadvantages of this technique for diagnosis of a lung abscess.

Advantages

  • Fast and inexpensive imaging modality

  • Exposes the patient to minimal ionizing radiation

  • Highly portable

  • May be highly sensitive for diagnosing a lung abscess

Disadvantages

  • Low specificity for diagnosis of a lung abscess

  • Less adept in detailing any underlying primary parenchymal or pleural process and any secondary complication

III. What are the contraindications for the first-line imaging technique?

  • No specific contraindications to plain radiography exist. Consent may be required for pregnant patients at some institutions.

IV. What alternative imaging techniques are available?

  • CT of the chest with intravenous contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of a lung abscess.

CT of the chest with intravenous contrast

Advantages

  • Gold standard in detecting and diagnosing a lung abscess

  • Highly sensitive and specific in detailing any underlying pulmonary process or any secondary complication

  • May help guide treatment

Disadvantages

  • Exposes patients to larger amounts of ionizing radiation

VI. What are the contraindications for the alternative imaging techniques?

CT of the chest with intravenous contrast

  • May be contraindicated in pregnant patients.

  • Contraindicated if there is an allergy to iodinated contrast

  • Relative contraindication in renal failure due to contrast exposure

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