Following a physical exam and patient history, we often use various imaging techniques to diagnose breathing problems. If a chest X-ray reveals an area of concern, we may then use computed tomography (CT) scans to take a closer look. Magnetic resonance imaging (MRI) is used to look at the blood vessels that carry blood to and from the lungs or the area in between the lungs called the mediastinum. Ultrasound is commonly used to diagnose pleural effusion, excess fluid in the space between the linings of the chest wall and outside of the lungs. A positron emission tomography and computed tomography (PET-CT) scan is an advanced nuclear medicine test predominately used for patients with lung and other types of cancer.
In addition to imaging tests, we also use physiologic testing. These are non-invasive tests that measure lung function, capacity, and chemical sensitivity. For patients with exercise-induced asthma, a baseline pulmonary function test is followed by an exercise induced bronchospasm study. Cardiopulmonary exercise testing is a comprehensive test that looks at the entire cardiac and respiratory system.
Minimally-invasive tests include bronchoscopy, which uses a flexible fiber optic tube to view the inside of the airways and lungs and take samples. X-ray guidance may be used to locate an area of concern and, with a tiny brush or needle, small samples of tissue can be taken for biopsy. Thoracentesis uses a needle to remove fluid from the pleural space for analysis. This allows us to determine the cause of pleural effusion.