Lung metastases

Lung metastases can be detected by plain film radiography, CT scan, or MRI (33). A plain chest radiograph is cheap, quick to perform and is often adequate to diagnose lung metastases. Spiral Ct can acquire an image in a single breath and provides increased sensitivity. It also detects a larger amount of nodules when multiple metastases are present. However, differentiation of benign conditions can be a problem, especially in the case of a solitary nodule. The diagnosis of lung metastases obviously has profound implications for the patient and her management. A histological diagnosis can be obtained in equivocal cases, either by percutaneous biopsy or using videoassisted thoracic surgery resection. Until recently, MRI has been too slow to accurately image the lungs. However, the advent of rapid gradient echo sequences allows imaging of the lung during a breath. As MRI provides excellent differentiation of parenchymal lesions and vascular structures, it may provide increased specificity in the diagnosis of lung metastases. Thus it is likely to have an increasing role in the future.

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