We aim to provide an educational pictorial review with the aid of multi-modality imaging to:
- illustrate pleural anatomy and the relationship to important intra-thoracic structures.
- provide a structured approach to benighandmalignantpathologies related to the pleura.
- highlight common pearls and pitfallsto aid radiological diagnosis.
Pleura = serous membranes that line the lungs and thoracic cavity.
Function = facilitate efficient respiration.
Visceral pleura - covers the lungs
Parietal pleura - covers the internal surface of the thoracic cavity. o Parietal pleura further subdivided into costal,
mediastinal and cervical surfaces.
o The blood supply differs for the two parts of the pleura,
with the parietal pleura being supplied by systemic vessels,
and the visceral pleura from the pulmonary and bronchial circulation.
The potential space between these two layers...
Findings and procedure details
Pathologies of the Pleura
· A collection of serous fluids within the pleural space.
· These can be divided into transudates or exudates using Light’s criteria (1).
· A pleural effusion will develop when the rates of formation and resorption of pleural fluid are unequal.
· Common causes are listed in table 1 (1).
Light's Criteria for Pleural Effusions (1)
Pleural LDH <2/3 upper limit of normal serum LDH
Pleural LDH > 2/3...
A sound understanding of pleural anatomy in combination with the knowledge of pathological conditions and differentiating features is key to accurate radiological diagnosis of a commonly encountered radiographic abnormality.
(1) Hooper C et al.
Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010.
2010;65 Suppl 2:ii4-17
Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation.
Malignant pleural mesothelioma: evaluation with CT,
(4) Dynes MC,