Radiographic and computed tomography (CT) imaging of complex pleural disease

Pleural diseases encompass a variety of complex appearances that are dependent on the underlying histologic features, location, and size. Chest radiography remains the most common imaging modality in the evaluation of suspected pleural disease. Computed tomography (CT) further delineates the cross-sectional anatomy, allowing visualization of the entire pleura, including the posterior recesses, mediastinal, and lateral pleural surfaces, which are frequently obscured on chest radiographs. CT imaging provides useful information to characterize the pleural disease in terms of tissue composition, location, and extent of disease. In this article, we review the use of two noninvasive techniques: chest radiography and computed tomography in the evaluation of complex pleural disease, benign and malignant pleural masses, pleural effusions, and pleural air collections.