High resolution computed tomography

High-resolution computed tomography
HRCT of lung showing extensive fibrosis possibly from usual interstitial pneumonitis. There is also a large emphysematous bulla.
ICD-9-CM	87.41
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High-resolution computed tomography (HRCT) is a type of computed tomography (CT) with specific techniques to enhance image resolution. It is used in the diagnosis of various health problems, though most commonly for lung disease, by assessing the lung parenchyma.

HRCT is performed using a conventional CT scanner. However, imaging parameters are chosen so as to maximize spatial resolution:

Depending on the suspected diagnosis, the scan may be performed in both inspiration and expiration. The patient may also lie prone (face down) rather than the more usual supine (face up).

As HRCT's aim is to assess a generalized lung disease, the test is conventionally performed by taking thin sections 10–40 mm apart. The result is a few images that should be representative of the lungs in general, but that cover only approximately one tenth of the lungs.

Because HRCT does not image the whole lungs (by using widely spaced thin sections), it is unsuitable for the assessment of lung cancer or other localised lung diseases. Similarly, HRCT images have very high levels of noise (due to thin sections and high-resolution algorithm), which may make them non-diagnostic for the soft-tissues of the mediastinum.

Intravenous contrast agents are not used for HRCT as the lung inherently has very high contrast (soft tissue against air), and the technique itself is unsuitable for assessment of the soft tissues and blood vessels, which are the major targets of contrast agents.

The technique of HRCT was developed with relatively slow CT scanners, which did not make use of multi-detector (MDCT) technology. The parameters of scan duration, z-axis resolution and coverage were interdependent. To cover the chest in a reasonable time period with a conventional chest CT scan required thick sections (e.g., 10mm thick) to ensure contiguous coverage. As performing contiguous thin sections required unacceptably prolonged scan time, HRCT examination was performed with widely spaced sections. Because of the different scan parameters for conventional and HRCT examinations, if a patient required both, they had to be performed sequentially.