Correct!
4. Thoracic CT
Thoracic CT is appropriate at this point. Thoracic MR would not be of benefit for the evaluation of focal lung opacities. While there are emerging data suggesting that MR of the thorax may be capable of characterizing lung disease, owing to improved scanner technology and faster scan times, the relatively poor signal intrinsic to lung limits the ability of MR to properly characterize pulmonary abnormalities compared with CT. 68Gallium [Ga]-citrate scanning is occasionally helpful for evaluation of diffuse inflammatory lung disease, but such is not the consideration here. 99mTc-MAA ventilation-perfusion scanning is useful the evaluation of suspected acute or chronic thromboembolic disease, but the focal lung opacity in this patient is less suggestive of thromboembolic disease and more consistent with either inflammation or a proliferative process. Decubitus imaging is used for the assessment pleural liquid- to determine of any effusion is free-flowing when the decubitus image is performed on the side with the pleural abnormality- and for assessment of possible air trapping, the latter when the decubitus imaging is performed on the side opposite of the lung suspected of air trapping or endobronchial obstruction. However, these considerations are not relevant for this patient.
The patient underwent enhanced thoracic CT (Figure 3).
Figure 3. Representative images from the thoracic CT in lung windows.
Which of the following is correct regarding the description of the thoracic CT findings? (Click on the correct answer to proceed to the fourth of seven panels)