Computed tomographic diagnosis of chronic obstructive pulmonary disease.

Recently, two-dimensional high-resolution computed tomography (2D-HRCT) and volumetric high-resolution computed tomography (VHRCT) have allowed great progress to be made in estimating small regions of hypoattenuation in the lung. VHRCT allows minimum-intensity projection (MINIP) imaging, which seems to be much more suitable than conventional 2D-HRCT for detecting subtle hypoattenuating regions, although the reliability of MINIP imaging data has not been conclusively shown. Three-dimensional computed tomography (3D-CT) images reconstructed from helical computed tomography (CT) acquisition over the whole lung field have been increasingly used to determine the absolute volume occupied by emphysematous changes. However, depending on the threshold CT values used for image reconstruction, whole-lung 3D-CT images may be distorted by considerable differences between the x-ray beam thickness and the effective section thickness, resulting in erroneous quantitation of emphysematous lesions by helical 3D-CT.

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