Thoracic CT for the intensivist.

OBJECTIVE To discuss the recent advances in computed tomography (CT) and to present a simplified approach to CT of the chest to facilitate the understanding and diagnosis of common acute thoracic abnormalities in the critically ill patient. DATA SOURCES Published articles and texts on thoracic disorders and CT diagnosis. SUMMARY OF REVIEW In the acutely ill patient with complex pulmonary and cardiac disorders a thoracic CT can be useful in determining the cardiac, pulmonary, pleural and mediastinal abnormalities present. With an understanding of the position and appearance of normal intrathoracic structures (and artifacts) acute thoracic disorders can be easily assessed by the non-radiologist, facilitating the correct diagnosis and the appropriate management. CONCLUSIONS Thoracic CT offers the intensive care specialist the option of evaluating the pulmonary system, pleura, mediastinum, heart, pericardium, and aorta where plain radiographs are often inadequate. New mobile CT technology offers CT to patients confined to the intensive care unit due to haemodynamic instability.