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Ultrasound exploration of the thorax is a very useful imaging method in children. For adults, it is useful for pleural effusion, study of the diaphragm and to guide percutaneous puncture of targeted pleuro-parietal, mediastinal or peripheral parenchymal sites. Thoracic ultrasound remains underused, particularly as a bedside exploration technique or in emergency or intensive care situations.

Interventional radiology of the thorax includes a wide variety of diagnostic and/or therapeutic procedures. Transthoracic needle biopsy is a widely used technique. Generall, computed tomography is used to guide the puncture, less commonly fluoroscopy or in exceptional cases ultrasound. Targets include parenchymatous, pleural and mediastinal lesions. The biopsy specimen is used for cytology, histology, bacteriology, mycology and parasitology studies. Needle biopsy is also the first step in more complex procedures: drainage of thoracic collections, inserting harpoons, thoracic sympatholysis, palliative treatment of aspergillomas. Bronchial arteriography with embolization is an effective emergency symptomatic treatment for severe hemoptysis. Endovascular vaso-occlusion procedures can be used for rare arteriovenous pulmonary fistulas. Superior vena cava obstruction can be treated, usually in a palliative procedure, by installing an endovascular endoprosthesis.

We report a case of a persistent middle-lobar pneumonia, which did not respond to antibiotics. Only a second bronchial endoscopy, with a third thoracic densitometry and histopathological results give the final diagnostic of tracheobronchial foreign body. The choking history happened more than 10 months before. The bronchoscopic extraction restablished the patient.

Magnetic resonance imagery (MRI) is less sensitive than computed tomography (CT) for the detection of pulmonary masses and cannot detect calcifications within such masses. MRI performed during the work-up for bronchial cancers has often been compared with CT scans: neither T nor N can be evaluated with more precision. Nevertheless, there are certain specific indications such as the exploration of proximal tumours with suspected extension into the mediastinum including cardiac and vascular invasion, tumours of the aorto-pulmonary window, the Pancoast-tobias syndromes, and tumours situated near the thoracic wall or the spine.

Magnetic resonance imaging (MRI) already has a number of indications in exploration of the mediastinum, the most frequent of which being exploration of vascular pathologies facilitated by visualization of vascular lumina without need for a contrast medium, MRI can provide detailed information concerning the size, relations and wall thickness of these vessels ans sometimes of aneurysmal thrombosis. It also makes it possible to study aortic dissections and venous diseases of the mediastinum. As regards mediastinal masses, MRI complements computerized tomography (CT): it is better than the latter to distinguish vascular relations and it provides aetiological arguments based on the intensity of T1 and T2-weighted signals.

In the study of the proximal airways, MRI is mainly appropriate for the trachea and the mainstem bronchi, in case of tracheal stenosis or tumors. CT remains the reference examination for the distal airways. In alveolar condensation, MRI may help differentiating some of the involved materials (blood, lipids). Lastly, the role of MRI is limited in interstitial pathology, even though some indications may be appearing: fibrosis following radiation therapy, determination of the inflammatory component.