On the chest radiograph the soft tissues present as areas of increased density that in part project next to the bony chest wall and in part overlay the different components of the chest. Abnormalities of the soft tissues will present as an abnormal increase or decrease in density often combined with the appearance of an abnormal contour or the disappearance of a normal contour.
Because of better density resolution and multiplanar reformatting, computed tomography (CT) can better demonstrate the different tissues of the chest wall. CT has the advantage over magnetic resonance imaging (MRI) of higher spatial resolution and the ability to better identify bony structures. MRI, however, yields greater soft-tissue contrast, which can be important. Multiplanar imaging and three-dimensional (3D) reformation can be performed with both techniques.
Ultrasound may also be used to examine the chest wall. In general it provides less detailed and comprehensive information but it usually enables the lesion to be localised, allows a distinction to be made between cystic and solid lesions and enables guided aspiration/biopsy to be performed under imaging control.
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