HIGH-RESOLUTION COMPUTED-TOMOGRAPHY OF PU LMONARY PARENCHYMA - PERSONAL-EXPERIENCE

High-resolution CT (HRCT) scans were performed on 156 patients, using a bone-reconstruction algorithm, 1.5 mm sections at 4 cm intervals fro m apex to base of the lungs and a 512x512 matrix. The patients either appeared to have a pathologic condition on chest film, or they present ed positive clinical symptoms - i.e., cough, dyspnea, fever - and ques tionable/negative chest films. Since HRCT is capable of showing the se condary lobule, we employed it to study both its anatomy and the alter ations that can modify its normal morphology - i.e., thickening of int erlobular septa, reticular pattern, nodular pattern, high-density area s, sub-pleural lines, honeycomb pattern. HRCT findings in secondary lo bules, airways, and pleura were examined. They were : lymphangitic spr ead of carcinoma, pulmonary fibrosis, sarcoidosis, pneumoconiosis, int erstitial edema, inflammatory disorders, bronchiectasis, emphysema, an d bullae. Even though some limitations still exist due to the non-spec ificity of HRCT findings, the latter is the best method currently avai lable to recognize and locate interstitial conditions and, sometimes, to make a diagnosis - e.g., of lymphangitic spread of carcinoma, inter stitial edema, fibrosis, emphysema, bronchiectasis. Moreover, HRCT can accurately locate pathologic areas for lung biopsy and can be used in stead of chest radiographs in the follow-up.