Chest enhanced CT lungs show no obvious abnormalities

In fact, some of the questions that many people ask come from their own physical examination reports. Sometimes these reports may be understandable to people, but sometimes they are incomprehensible. For example, if the chest enhanced CT scan shows no obvious abnormalities in the lungs, what does this report mean? Let us take a look at the introduction about them below.

Clinical significance

1. Chest wall: Asbestosis with pleural thickening that cannot be shown on chest X-rays can be found; when there is pleural effusion, if small pleural nodules or masses are found, it is helpful for the diagnosis of metastases and mesothelioma; based on the CT value of pleural masses, encapsulated effusion, localized mesothelioma and extrapleural lipoma can be distinguished; chest wall hemangioma can be diagnosed with the help of CT enhancement; rib fractures and rib destruction can be well displayed.

2. Lungs: It is valuable for the early diagnosis of peripheral lung cancer. It is helpful for the diagnosis of central lung cancer when the main bronchi, lobar bronchi and segmental bronchi are narrowed or truncated. High-resolution CT (HRCT) may show diffuse interstitial lesions that cannot be shown on chest X-rays, which is helpful for early diagnosis and differential diagnosis. It can also detect bullae, bronchiectasis, and smaller tuberculosis cavities that cannot be shown on chest X-rays.

3. Mediastinum: It can detect enlarged lymph nodes that cannot be found on chest X-rays. It helps in the qualitative diagnosis of mediastinal masses based on the CT value and location of the masses. It can also be used to differentiate between fatty, cystic, and solid masses. Enhanced scanning can diagnose pulmonary artery aneurysms and aortic aneurysms.

4. CT angiography can be used for pulmonary artery angiography examination, which can better display the pulmonary artery vascular branches above the subsegmental level and can be used for the diagnosis of pulmonary embolism.

5. CT simulation endoscopy can display segmental and subsegmental bronchi non-invasively, and can observe lesions from the distal end of bronchial cavity obstruction and stenosis; at the same time, it can display multi-directional extraluminal anatomical structures, and can accurately locate and determine the scope of extramural tumors.

6. Since CT is a tomographic scan and has a density resolution 10 times higher than a chest X-ray, it can easily detect tiny nodules with a diameter of less than 2 mm.

Scanning significance

1. It helps to make a qualitative diagnosis of problems found on chest X-rays: Mass: (1) Differentiate whether the mass is cystic, solid, fatty, or calcified; (2) Determine the location and extent of the mass, and find out the anatomical connection between the mass and the mediastinum.

2. Based on clinical needs, it can detect hidden sources of disease that are not found in chest X-rays: (1) It can identify the presence of micrometastases and show the presence, location, size, and number of tumors, so as to formulate treatment plans. (2) CT-guided percutaneous biopsy enables histological diagnosis of certain tumors. (3) If chest X-ray and fiberoptic bronchoscopy are negative but sputum tumor cells are positive, CT should be performed to identify the source of the tumor in the lungs.

3. CT is inferior to X-ray in determining the degree and morphology of bronchial infiltration and stenosis, and is even inferior to bronchography.