Computed tomography of the thorax: a status report

Computed tomography (CT) of the thorax shows early promise of important diagnostic advances. We believe that CT often provides information superior to that provided by standard roentgenographic techniques, is capable of significantly influencing patient management, and in selected instances, offers unique information not available by other methods. Computed tomography permits the imaging of mediastinal structures not possible with conventional roentgenographic methods and can diagnose with certainty benign mediastinal conditions such as pericardial cysts and focal or diffuse accumulations of fat. It is ideal for detecting pleural abnormalities and for displaying underlying parenchymal disease in patients with complex pleuroparenchymal shadows on conventional films. Pulmonary metastases unseen on the plain chest film can be detected with greater sensitivity than by any other method. Future applications of CT include the staging of mediastinal lymph nodes in bronchogenic carcinoma, the differentiation of benign from malignant solitary pulmonary nodules, and the detection of diffuse diseases involving the lung parenchyma before they are visible on conventional roentgenograms. Additional clinical experience and careful studies will determine CTs final role as a diagnostic aid for disorders of the thorax.