Which of the following CT findings most reliably distinguishes an exudative from a transudative pleural effusion?
- A Bilateral effusion
- B Pleural thickening and enhancement after IV contrast ✓
- C Hyperdense fluid on non-contrast CT
- D Dependent layering of fluid
Correct answer: B. Pleural thickening and enhancement after IV contrast
Explanation
Pleural thickening and enhancement after intravenous contrast on CT indicates pleural inflammation or neoplasm, both causes of exudative effusion. Transudates generally show no pleural thickening or enhancement. Bilateral effusions are more suggestive of transudate (heart failure) but are not specific. Hyperdense fluid on CT may suggest hemorrhage or empyema, which are exudates, but is not universally present. Dependent layering is non-specific.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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