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The tests most commonly used to diagnose and evaluate pleural effusion include:
1. Chest x-ray.
2. Computed tomography (CT) scan of the chest.
3. Ultrasound of the chest.
4. Thoracentesis (a needle is inserted between the ribs to remove a biopsy, or sample of fluid).
5. Pleural fluid analysis (an examination of the fluid removed from the pleura space)
When the pleural effusion has remained undiagnosed despite previous, less-invasive tests, thoracoscopy may be performed. Thoracoscopy is a minimally invasive technique, also known as video-assisted thoracoscopic surgery, or VATS, performed under general anesthesia that allows for a visual evaluation of the pleura). Often, treatment of the effusion is combined with diagnosis in these cases.