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 |