VALUE OF HRCT (HIGH RESOLUTION
CT SCAN) OF THE LUNGS IN PRIVATE PRACTICE
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof.
of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
There are three important uses of this test
which is done in the CT Scan Department.
1. A patient having repeated attacks of passing blood clots in the sputum over
years - the most common cause of this complaint is tuberculous bronchiectasis.
Unfortunately, this is never seen on X-ray chest which shows only some fibrotic
strands or calci-nodular shadows which the GPs are tempted to treat as active
Kochs. Once the HRCT of the lungs establishes this diagnosis, the patients will
have to be taught to learn to live with this complaint life time, unless surgical
removal of that segment of the lung is done.
2.COPD patients - It is always better to ask for HRCT in all these patients.
If HRCT of the lung does not show areas of emphysematous bullae, the prognosis
and management of this patient with bronchodilators and steroid inhalers is
much better. The quality of life can be improved much more than the patients
who have these bullae seen on HRCT.
3.Once the diagnosis of interstitial lung disease (ILD) is suspected, HRCT will
have to be done to confirm this diagnosis and to guide the doctor regarding
the dose of steroids which have to be given permanently. The prognosis of this
disease is extremely poor and most of these young and middle aged patients die
within a few years since the onset of the disease.