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In a mass chest computed tomography (CT) screening using a mobile helical CT unit, we measured the aortic diameter at three segments to confirm standard values and also attempted to detect any asymptomatic aortic aneurysms. The population screened in the present study consisted of 6971 subjects (3847 men and 3124 women, mean age 60.3 +/- 12.1 years). They underwent a plain chest CT to screen for lung cancer and tuberculosis. The diameters of the ascending and descending aorta were measured at the level of the pulmonary artery bifurcation. The abdominal aorta was measured at the level of the celiac bifurcation, and the mean values for each measurement were calculated. In addition, we attempted to determine whether any correlation exists among aortic diameter, age, and indices of body size and investigated the frequency of asymptomatic aortic aneurysms among the general population. The mean aortic diameter of all three segments was significantly larger in men than in women and increased with age. It also correlated significantly with indices of body size (P < 0.01). A total of 11 subjects (0.16%) had asymptomatic aortic aneurysms (3 ascending, 4 descending, and 4 thoracoabdominal). The aortic diameter in each individual case was greater than the mean aortic diameter +3 standard deviations in each age group. Chest CT screening for lung cancer can thus detect asymptomatic aneurysms through simultaneous aortic measurement.

The current medical system provides medical services to patients who visit hospitals. However, medical services can be provided at or close to the home of the patient using fully equipped mobile telemedicine systems. Such a system can identify the disease at an early stage, improve quality of life and prognosis through early diagnosis and treatment, and reduce the costs of medical service. Furthermore, the unit can provide mass screenings of the population, as well as full medical service to remote areas. The Telecommunications Advanced Organization of Japan, Matsumoto, Japan, and Shinshu University Hospital, Matsumoto, Japan, established a research center for a unique telemedicine project using a mobile system. The mobile unit consists of a van that houses a spiral computed-tomography (CT) machine and various telecommunications equipment. The unit allows medical examination, CT scanning, and on-line two-way transfer of image data/teleconferencing to a medical center for consultation with various specialists. We have used the system thus far for the early detection of lung cancer through mass screenings over a four-year period in 29 administrative districts. Mass screenings of 19117 residents resulted in the identification of 75 cases of early lung cancer who were later treated by partial pneumonectomy at Shinshu University Hospital and affiliated hospitals. We have also used the system to provide medical services to rural areas, as telemedicine support at remote areas, wintertime telemedicine support to an international sports competition, and various medical services to a home-care facility.

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