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Table 1 Different imaging modalities used in the evaluation of thoracic hernias

From: Imaging of thoracic hernias: types and complications

  Advantages Disadvantages Indications
Chest radiograph Inexpensive; readily available Limited sensitivity and specificity Reasonable first test screening
Ultrasound Portable; inexpensive; widely available; real-time data Operator dependent; limited by acoustic window in the chest, especially in large patients Prenatal and paediatric group, where radiation dose is a concern
CT Good spatial resolution providing anatomical detail; wide field of view; multi-planar reconstruction Radiation exposure; potentially nephrotoxic iodinated contrast Comprehensive evaluation of thoracic hernia-establishing diagnosis; characterising the type; identifying contents; detecting complications; providing road map to intervention/surgery
MRI Good spatial resolution; excellent contrast resolution; multi-planar acquisition; wide field of view Limited to a few of centres; time-consuming; expensive; contraindications Further classification of diaphragmatic hernias and hernias, particularly those involving cardiac structures
Fluoroscopy Real-time anatomical and physiological information Radiation exposure; requires patient cooperation Evaluation and classification of hiatal hernias; gastrointestinal leaks