Imaging

Bronchogenic/enteric/pleuropericardial cyst

Preliminary Diagnosis: Bronchogenic/Enteric/Pleuropericardial Cyst

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

  • Chest radiographs: PA and lateral views and a dedicated abdominal series of radiographs

II. Describe the advantages and disadvantages of this technique for diagnosis of bronchogenic/enteric/pleuropericardial cyst.

Advantages

  • Highly portable

  • Inexpensive relative to other modalities

  • Exposes patients to minimal ionizing radiation

Disadvantages

  • Less sensitive and specific in evaluating for bronchopulmonary foregut malformations in the chest or abdomen compared with cross-sectional imaging (e.g., CT)

  • Less adept in directing treatment compared with cross-sectional imaging

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

No specific contraindications to plain radiography exist.

IV. What alternative imaging techniques are available?

  • CT of the chest and/or abdomen and pelvis with contrast

  • MRI of the chest and/or abdomen and pelvis with contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of bronchogenic/enteric/pleuropericardial cyst.

CT of the chest and/or abdomen and pelvis with contrast

Advantages

  • May help guide treatment

  • Much more sensitive and specific in diagnosing any underlying primary process or any potential secondary complication than plain radiography

Disadvantages

  • Exposes patients to more ionizing radiation than plain radiography

  • Less portable than plain radiography

  • More expensive compared with plain radiography

MRI of the chest and/or abdomen and pelvis with contrast

Advantages

  • Does not expose the patient to any ionizing radiation

  • May further help characterize the lesion and generate a more specific and comprehensive differential diagnosis

Disadvantages

  • May be subject to motion artifact due to length of the exam, which degrades image quality

  • Less adept at detailing osseous structures

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

CT of the chest and/or abdomen and pelvis with contrast

May be contraindicated in pregnant patients

MRI of the chest and/or abdomen and pelvis with contrast

Contraindicated in patients with non-MR-compatible hardware

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