ABSTRACT
Computed tomography (CT) of the chest has proven useful for a variety of indications (Table 1). Although standard protocols suffice for the majority of chest CT examinations, it is important to recognize that the scan must often be tailored to the individual patient so that the appropriate acquisition parameters are utilized and useful information is ob tained. In addition, proper communication with the radiologist, either by providing detailed history and pertinent physiological data on the radiological requisition or by telephone,
1. Staging of lung cancer
2. Detection of metastatic disease
3. Evaluation of complex pleuroparenchymal infection (abscess, empyema)
4. Detection/characterization of chronic infil trative lung disease/bronchiectasis
5. Solitary pulmonary nodule
6. Detection of pulmonary emboli
7. Aortic disease (aneurysm, dissection)
8. Rule out tracheobronchial lesion (hemo ptysis)
Contrast-enhanced 5-to 7-mm helical scans from apex through liver
Contrast-enhanced 5-to 7-mm helical scans from apex to base
Contrast-enhanced 7-to 10-mm helical scans from apex to base
High resolution 1-mm scans every 10 mm with expiratory scans
Noncontrast 1-mm helical scans through nod ule with densitometry
Contrast-enhanced З-mm helical scans from arch to lower lobe for 12-cm distance
Nonenhanced helical scans apex to base to de tect intramural blood, then enhanced helical scans from apex to aortic bifurcation
Noncontrast З-mm helical scans from thoracic inlet to proximal lower lobe segmental bronchi
1. Detection of disease in patients with normal chest radiographs and clinical/functional suspicion of infiltrative disease/emphysema
2. Specific characterization of lung disease in patients with nonspecific radiographic and clinical findings
3. Preoperative localization for choosing site of transbronchial/open lung biopsy 4. Determining the degree of disease activity in patients with diffuse infiltrative lung disease 5. Assessing reponse to therapy or progression of underlying disease 6. Determining the presence and extent of bronchiectasis
is an essential part of the consultative process and optimizes the quality of the CT interpre tation.
