Correct!
4. Contrast-enhanced thoracic CT
Contrast-enhanced thoracic CT is the most appropriate modality for the investigation of the patient’s chest radiographic abnormalities. Contrast-enhanced thoracic MRI could provide information similar to that obtainable with thoracic CT, but the evaluation of the lung parenchyma and airways is far more efficacious with CT than MRI. 18FDG-PET scan is primarily used for lung cancer staging and the investigation of the indeterminate solitary pulmonary nodule and mediastinal abnormalities, and could prove useful subsequently, but is premature at this point. Similarly, bronchoscopy may prove valuable if an abnormality of the central lung, peribronchial regions, mediastinum, or airways is found, but is also premature at this point. 133Xe-Ventilation – 99m Tc-perfusion scintigraphy could demonstrate the presence of either airway or vascular abnormalities contributing to the chest radiographic abnormalities, but often the findings at ventilation / perfusion scintigraphy are relatively non-specific and require interpretation in light of information from anatomic studies. The chest radiographic findings are not suggestive of thromboembolic disease, so 133Xe-Ventilation – 99m Tc-perfusion scintigraphy’s role in the evaluation of that disorder is not relevant for this patient.
The patient underwent contrast-enhanced thoracic CT for further investigation of the chest radiographic findings (Figure 2).
Figure 2. Representative images from the axial contrast-enhanced thoracic CT displayed in soft tissue windows (A-I, upper left) and lung windows (J-R, upper right). Videos of thoracic CT displayed in soft tissue windows (lower left) and lung windows (lower right).
Which of the following statements regarding this imaging study is most accurate? (Click on the correct answer to proceed to the fifth of nine pages)