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OP Kapoor

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.

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