Correct!
3. Enhanced thoracic CT

Enhanced thoracic CT would provide an excellent means for characterization of the patient’s chest radiographic findings. Flexible fiberoptic bronchoscopy with transbronchial biopsy is not a “wrong” answer, in that this technique could provide useful diagnostic information in this patient with extensive interstitial thickening. However, the procedure is premature at this point- further non-invasive characterization could provide information that alters the subsequent management options for this patient. While diffuse pulmonary parenchymal abnormalities are present, there is no suitable target for percutaneous transthoracic lung biopsy- this procedure is typically employed to obtain a tissue diagnosis for patient with focal pulmonary diseases, particularly pulmonary nodules.   68Ga-citrate scanning is occasionally used for the assessment of diffuse lung disorders, but the result of this examination are rarely diagnostic and the examination is often of limited utility. 18FFDG-PET scanning is also premature at this point, as this imaging modality is most commonly used in the staging of known malignancy or the assessment of indeterminate pulmonary nodules; 18FFDG-PET does not typically play a role in the assessment of diffuse pulmonary parenchymal abnormalities.

Enhanced thoracic CT (Figure 3) was performed.

Figure 3. Enhanced thoracic CT displayed in lung (A-E) and soft tissue (F) windows.

Which of the following statements regarding this imaging study is most accurate? (Click on the correct answer to proceed to the seventh of eight pages)

  1. The enhanced thoracic CT shows acute pulmonary embolism
  2. The enhanced thoracic CT shows aortic dissection
  3. The enhanced thoracic CT shows extensive interlobular septal thickening and pericardial effusion
  4. The enhanced thoracic CT shows numerous small pulmonary nodules
  5. The enhanced thoracic CT shows pneumothorax

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