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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