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What is a computed tomography of the lungs?
In medicine, a computed tomography (CT) scan is an imaging method. With the help of X-rays, cross-sectional radiographs of the human body are obtained, based on which three-dimensional images can be generated. For this purpose, the X-ray source rotates around the patient. Nowadays, CT is a widely used examination method, mainly because of its rapid completion within just a few minutes and the progressively high resolution of the pictures following its technical evolution. This procedure allows for quick and reliable diagnosis of many illnesses. CT examinations of the lungs and chest are also often carried out to assess anatomical features, tissue composition and potential abnormalities.
What is visible in a CT scan of the lungs?
First of all, it is possible to evaluate the lung tissue (so-called parenchyma) using a lung CT. For instance, inflammatory processes, scarring, fibrosis (connective tissue remodeling) or air-filled cavities (such as in emphysema) can be identified. Accumulations of fluids, such as pus, blood or water in the tissue, can also be visualized. This makes it possible to clearly identify many clinical conditions.
Additionally, with the use of contrast agents the blood flow to the lungs can also be displayed, which becomes important in cases of vascular occlusion, for example. Even minute tumors of the lung can be detected on a CT scan, making it possible to diagnose, examine and treat them at an earlier stage.
Also, the bones of the chest, the heart and large vessels like the aorta can be analyzed.
When is a lung CT done?
Generally, a lung CT can take place as a separate examination or as part of a whole-body CT, which is often performed in emergency situations (like a traffic accident) where different injuries, some of them severe, are presumed to have been sustained. As a result, possible abnormalities in the entire body can be recognized and quickly treated within a few minutes.
A simple lung CT is performed, among other things, for the diagnosis of pneumonia, especially if a physical examination or a conventional X-ray is not sufficient to make a reliable diagnosis.
Also chronic lung diseases like emphysema , pulmonary fibrosis or cystic fibrosis due to genetic factors may be further investigated by computed tomography. CT scans also provide detailed information on specific conditions, such as suspected asbestosis or sarcoidosis. Likewise it can provide data in the case of constrictions of the trachea or bronchi.
CT is extremely important when lung tumors are suspected as in the best case, even very small tumors of just few millimeters can be identified on a CT scan. Apart from that, the tumor location, spread and potential infiltration into other organs can be judged, so can possible metastases. For planning therapy, this is crucial. To some extent, CT also makes it possible to differentiate between benign and malignant tumors with regard to their growth behavior and specific characteristic features.
A CT scan with administration of a contrast agent is required if pulmonary artery embolism, that is a vascular occlusion, is suspected. In the worst case, this can be life-threatening.
How does a CT of the lungs work?
Prior to a CT scan, the patient is provided with information about the benefits and possible risks of the examination. History of disease, current medications and allergies are discussed, and it is essential to note any allergies to contrast agents or irregularities observed during previous CT examinations. Should a contrast medium be required, the kidney and thyroid function must also be determined in advance using blood tests.
Patients do not need to be fasting for the scan itself. IV access will be established only if necessary. For the CT examination, patients are asked to lie on their back on a table. which will then be moved into the tubular or arc-shaped CT device. During the procedure, patients should remain as still as possible to avoid any artifacts and blurred images. They may be asked to hold their breath briefly. The medical staff will inform the patient about any necessary actions. During the scan itself, the patient will be alone in the room because of the burden coming from the X-rays, but via an integrated intercom system they can contact the medical staff any time about urgent concerns or questions.
A contrast agent is injected into the bloodstream if needed.
Usually, the procedure will take anywhere from 5 to 30 minutes and is totally painless for the patient.
What are the costs of a CT scan of the lungs?
Normally, public health insurances cover the costs associated with a CT scan of the lungs if medically indicated. These cost about 200-500 euros, depending on whether contrast agents were used or additional medical services were necessary.
Are there any risks and adverse effects?
A computed tomography is associated with a radiation exposure (X-rays). This exposure is higher for a CT than it is for a conventional X-ray of the lungs. While acute radiation damage to the skin, for instance, is very rare, long-term risks like radiation-induced damage to the genome, which may lead to cancer, are the most serious concern. This is why CT scans should be performed only if there is a relevant, justified medical indication, or if other tests are inconclusive or not available. If all of the above is taken into account, the benefits and advantages of CT usually exceed its risks. A single CT examination is usually safe. During pregnancy, however, it should not be carried out to avoid increased radiation exposure to the unborn child; Very urgent and life-threatening emergencies may be excluded from this rule.
Nowadays, so-called low-dose CT scans are frequently conducted, as they generate a lower radiation exposure.
The contrast medium, which is given in some cases, represents a further risk of the scan. Some patients may experience discomfort, dizziness, nausea or headaches. A true allergy to contrast agents can trigger severe anaphylactic reactions, even a circulatory shock. Particularly for patients suffering from thyroid or kidney diseases, the contrast medium may be problematic, so this should always be disclosed and discussed before the examination.
Which doctors and clinics specialize in CT of the lungs?
Just like other medical imaging techniques, CT examinations are carried out and evaluated by radiologists. This may be accomplished in outpatient offices or during a hospital stay. In many cases, patients with a pulmonary disease will be referred to a radiology practice or department for a CT scan. Nevertheless, such a referral can also be provided by a general practitioner, for instance, if the indication is justified.
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