Indications for computed tomography of the chest

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Computer scanning helps to establish a diagnosis in the most difficult cases

Chest CT is an advanced X-ray imaging technique that uses radiation to create detailed images of the sternum, sternoclavicular joints, ribs, adjacent soft tissues, and organs (primarily the lungs).

The study is carried out if, after a routine x-ray, the cause of the complaint remains unclear or there is a suspicion of a pathological process in this area.

A CT scan of the chest may be performed as an alternative to an MRI if the patient has a contraindication to an MRI scan. For better visualization, a contrast agent may be injected.

The main advantage of CT is its ability to simultaneously demonstrate bone, soft tissue (with contrast), and blood vessels.

What does a chest CT scan show?

Multislice CT chest, 3D reconstruction 

Experts distinguish three areas in the mediastinum: central (vascular space with the pericardium and its contents, vessels and lymph nodes), anterior (fatty tissue, thymus gland, internal mammary arteries and lymphoid tissues) and posterior (trachea, esophagus, descending thoracic aorta, lymph nodes and paravertebral spaces of the chest). Accordingly, all pathological processes that occur in these areas can be visible.

The sternum, ribs and their articulations - the main structures of the anterior chest wall - are susceptible to various anatomical anomalies and pathological processes, which in some cases require treatment.

The doctor will justifiably refer you for a diagnostic procedure if the patient has an unexplained prolonged cough, chest pain, hemoptysis, enlarged regional lymph nodes, limited shoulder movement, stiffness in the thoracic spine, etc.

A CT scan of the chest and mediastinum may show the following changes:

• Degenerative-dystrophic diseases.

Osteoarthritis (osteoarthritis) is a common pathology, most often affecting the sternoclavicular joints.

A CT scan, unlike an x-ray, can show subchondral sclerosis, cysts, narrowing of the joint space, and changes in the fibrocartilaginous tissue of the disc.

Seronegative arthritis, gout and some other diseases can also affect the connections of the sternum with each other and with surrounding bone structures, which is clearly visible on CT scans.

 Changes that are visible on a CT scan of the chest include inflammatory processes in solid structures (destruction of articular surfaces, widening of the joint space), in organs and tissues (diffuse infiltration, accumulation of fluid, gas, blurred boundaries, reactive enlargement of lymph nodes).

Complicated pneumonia, pleurisy, abscess of the lung and soft tissues of the chest can be diagnosed using CT. The study also shows changes in the heart and valve apparatus.

• Acute and traumatic conditions.

As a result of strong physical impact (usually due to an accident), one or more fractures of the sternum occur. Computed tomography allows you to diagnose combined injuries (damage to the ribs, thoracic spine, lungs and heart) and complications (pulmonary atelectasis, hemo- and pneumothorax, hemopericardium).

Spontaneous sternal fractures occur in the presence of a neoplasm (multiple myeloma, metastasis), osteoporosis and can mimic acute coronary diseases. Using chest CT, it is possible to diagnose congenital vascular anomalies or acquired pathologies: pulmonary embolism, aortic dissection, etc.

According to CT data, the causes of ischemia and dysfunction of the heart valves are identified.

• Postoperative complications.

After performing a sternotomy (the operation provides better access to the heart), there is a possibility of complications: wound dehiscence, secondary osteomyelitis of the sternum or ribs, mediastinitis and mediastinal hematoma, pleural effusion.

After surgical interventions on the heart and blood vessels, adverse consequences may develop (infection of pacemaker electrodes, infectious and inflammatory complications, etc.). These conditions are differentiated using CT from normal postoperative changes. In such patients, dynamic computer scanning is performed.

Complications may also be present after interventions on the lungs and other structures. In emergency situations, the advantage of CT is the speed of obtaining results.

• Neoplasms and metastasis.

Most neoplastic processes of the sternum are metastatic in nature, which is explained by direct penetration from neighboring organs or by hematogenous route.

Breast, thyroid, lung, kidney, colon and lymphoma cancers are the most common sources of sternal metastases.

Chest CT with contrast is the gold standard in diagnosing lung cancer, allowing you to see changes at the initial stage, at which radical treatment is possible.

Computer scanning also shows mediastinal neoplasms, which are diverse in morphology and genesis. The most common are thymomas, cysts, neurogenic tumors, and malignant lymphomas. Scanning for dysphagia may suggest esophageal cancer, but in all cases the final diagnosis is confirmed by morphological examination.

Patients often ask the question: “What should I do - CT or MRI of the chest?” Each study has its own indications and contraindications, but the methods are often complementary. Specialists at the diagnostic center can suggest what is preferable in each specific case, but it is better if you have a referral from your attending physician.

How is a chest CT scan done?

Patient position during chest CT

You must pre-register for the diagnostic procedure, but it can be performed on the day of your visit, for health reasons. Modern CT scanners can examine large areas of the body in just a few seconds, which is especially suitable for patients who have difficulty immobilizing for long periods of time and young children.

The X-ray technician places the patient on the table; restraint straps and pillows may be used to ensure immobility. Excessive mobility leads to blurred images. The progress of the procedure is monitored from the adjacent room, through glass. For emergencies, there is a button to contact staff.

The table with the patient slides deep into the tomograph, and many X-ray sensors begin to rotate around the body, transmitting cross-sectional images of the chest to the monitor screen. Images can be reformatted into other planes using a special computer program.

The data obtained as a result of diagnostics can be easily transferred to any medium or printed. There are no unpleasant sensations during a CT scan of the chest and mediastinum; the technical noise produced by operating equipment can be leveled out by using headphones.

The scanning lasts less than a minute, the entire procedure with preparation and installation takes no more than half an hour.

To improve visualization, in some cases (mainly in the diagnosis of malignant neoplasms and to assess the dynamics after chemoradiotherapy), a chest CT scan with contrast is performed.

Computed tomography enhanced with a radiopharmaceutical helps to clarify the diagnosis of tuberculosis (the number of foci, their location, the condition of the lymph nodes), but the final verification occurs after evaluating the results of a comprehensive examination (Mantoux test, Diaskintest, and, if necessary, biopsy). Inflammation and damage to the lung parenchyma are usually clearly visible on non-contrast-enhanced CT. If there are concerns about complications, a radiopharmaceutical can help further determine the severity of the pathological process.

CT scans of the chest organs are performed for children exclusively for health reasons in special diagnostic centers at pediatric clinics.

Preparing for the study

Before undergoing diagnostics, make sure there are no contraindications

Preparation for a CT scan of the sternum does not imply any lengthy activities; for a native study, it is enough to choose comfortable clothing without metal and remove jewelry.

If a contrast agent is to be administered, you should have a light snack 40-50 minutes before the procedure, which will help prevent or reduce autonomic reactions (mild nausea, drooling, dizziness).

Patients suffering from diabetes and taking Metformin, in agreement with the endocrinologist, should stop taking the drug 48 hours before the procedure. During lactation, it is recommended to stock up on milk for two feedings.

Indications and contraindications for CT scan of the sternum

A CT scan of the sternum is part of a CT scan of the chest. Diagnosis is not a routine examination method and is performed if the cause of the disease remains unclear or changes in radiographs require clarification.

We list the main indications for CT scan of the sternum and chest:

• suspicion of a pathological process in the lungs, pleura, heart, sternum, joints, mediastinum;
• post-traumatic diagnosis;
• pre- and postoperative examination;
• determination of the zone for radiation exposure for malignant neoplasms of the corresponding area;
• tracking dynamics after treatment.

Contraindications to CT scan of the sternum and chest cavity

Modern equipment makes it possible to minimize radiation exposure by 1.5-2 times compared to conventional radiography: CT OGK is safe for most people. Exceptions are pregnant women and children under 14 years of age. For technical reasons, the diagnostic procedure is not feasible in patients with severe obesity (above 150 kg).

Contraindications to contrast contrast:

• chronic renal failure with increased creatinine levels;
• hyperthyroidism;
• polyvalent allergy.

The administration of a tracer drug is unacceptable if a serious hypersensitivity reaction such as Quincke's edema or anaphylaxis developed during or after the previous contrast. Mild nausea, metallic taste, dizziness, and hot flashes are considered normal and are not contraindications to enhanced CT scanning.

The images are decrypted on the same day. The resulting images are analyzed by a radiologist, who issues a conclusion. Determining the correct diagnosis is not easy, because among several dozen shades of black, gray and white, it is necessary to isolate the one that does not correspond to the norm and interpret the result. Let us present to your attention several photos of chest tomography:

A non-contrast CT scan in a patient with a history of interstitial lung disease and a right lung transplant shows a narrowed area of ​​the right bronchial anastomosis (red arrow). The left lung is reduced in size, with signs of bronchiectasis and bronchiolectasis (black arrow). Narrowing of the central airway during expiration in a transplanted lung (blue arrow).

Effusion (red arrows) in both pleural cavities.

At the Magnit diagnostic center in St. Petersburg, you can do a CT scan of the chest organs, pre-registration through the website form or by phone: +7 (812) 407-32-31.

Source: https://spb24mrt.ru/kt-info/chto-pokazyvaet-kt-grudnoj-kletki

Computed tomography (CT) of the chest

Computed tomography of the chest is considered one of the most informative ways to examine patients who come with complaints of unpleasant symptoms in this part of the body. In such cases, first of all, doctors prescribe x-rays to get a general idea of ​​the condition of the organs and tissues in the chest, and then prescribe more specific examinations - magnetic resonance or computed tomography. Such techniques reveal disturbances in the structure and functioning of the organs of the chest and mediastinum: heart, lungs, esophagus, aorta, pulmonary artery, trachea, soft tissues and vessels of various locations.

What are the organs of the chest and what functions do they perform?

It is not for nothing that the rib cage has such a name - it is formed by a “cage” of ribs, the rear ends of which are connected to the thoracic spine, and the front ends to the sternum. From below, the chest cavity is supported, as it were, by the diaphragm. Within this cavity there is the heart, lungs, large veins and arteries, trachea, esophagus, nerves, and the thymus gland is located behind the sternum.

The heart is the central organ in the body's circulatory system; it works on the principle of a pump, continuously circulating blood in the body. The lungs, in turn, are responsible for oxygen saturation processes and perform the respiratory function. They are the largest paired organ of the human body.

The thymus gland is part of the endocrine system, takes part in hematopoiesis and the functioning of the immune system, and regulates growth processes.

The trachea is a tube that consists of cartilaginous half-rings, connective ligaments and muscle tissue on the back wall. Below it is divided into two main bronchi. The main purpose of the trachea is to transmit air to the bronchi.

The esophagus is also shaped like a tube that connects the larynx and stomach. Through it, food enters the gastric cavity for digestion.

CT – This abbreviation stands for computed tomography. It is a type of x-ray examination.

Through a special method of directed exposure of X-rays to the human body, a radiologist receives a layer-by-layer image of the internal organs of the human body, down to the smallest details, and with the ability to construct a three-dimensional model on the screen.

Distributed throughout the tissues, vessels and cavities, the contrast gives the images on the tomograph monitor or the resulting images a clear and clearly visible appearance.

By the accumulation of contrast in one or another part of the organ, one can judge the presence of functional pathologies or abnormalities in that place.

A computed tomography scan of the chest is necessary to:

• determine the presence and number of tumors in the chest cavity;
• assess the severity of diseases of the organs localized in it;
• develop a treatment regimen;
• assess the condition of the lymph nodes in the mediastinum;
• indicate the extent of spread of the neck tumor to the chest organs;
• evaluate the characteristics of the primary tumor and its ability to spread metastases.

In fact, in addition to simple rules for preparing for the procedure, tomography itself is a simple and quick method for studying the state of the human body.

Both doctors and examinees recognize it as one of the most comfortable and painless methods of examination.

After all, the patient is not required to do anything other than take a comfortable lying position and occasionally hold his breath for a short time. However, this procedure also has its own characteristics.

In what cases is a chest CT scan prescribed?

Carrying out a CT procedure is associated with a certain amount of risks, primarily associated with the radiation to which the patient is exposed during the scan.

Typically, the procedure is performed at the discretion of the attending physician, and in order for a person to be admitted to it, a documented referral signed and stamped by the doctor will be required.

A specialist may consider it appropriate to perform a CT scan if there are the following indications:

• X-ray negative pneumonia;
• neoplasms of any etiology in the lungs or mediastinal organs;
• metastases in the lymph nodes of the chest, lymphadenopathy, lymphogranulomatosis;
• sarcoidosis, pleurisy, tuberculosis, abscess and parasitic cysts of the lungs, mediastinitis, heart disease and large blood vessels, atelectasis, chest trauma;
• pathological conditions of the bronchi;
• the need to evaluate the effectiveness of treatment for diseases of the chest organs;
• preparation for surgical intervention;
• detection of changes of unknown etiology on x-rays;
• clarification of the diagnosis;
• the presence of congenital and acquired defects of the chest organs.

All of the above deviations can be detected and visualized by computed tomography, if they were not previously noted and did not manifest themselves in any way in the patient. However, CT is rarely performed as a preventive procedure.

For early detection of diseases of the chest organs and prevention of their development, doctors advise undergoing fluorography once a year.

If a person exhibits characteristic symptoms, and the X-ray data obtained indicate the presence of disorders, a chest scan with a tomograph would be quite appropriate.

CT scanning is not always possible for the patient. The grounds for prohibiting tomography in a particular case may be:

• state of pregnancy or breastfeeding (to avoid possible harm to the baby);
• patient age under 3 years;
• diseases that cause spasms and convulsions (since the subject must remain motionless during the scanning process).

It is not always possible to conduct a CT scan for a person with a body weight above a certain mark. Conventional tomographs are designed to weigh no more than 140-180 kg.

Children over 3 years of age may be prescribed a chest CT scan at the discretion of the attending physician, however, only if there is a special need. In other cases, a more harmless MRI should be used.

When using a contrast agent during the study, additional contraindications are added:

• the presence of bronchial asthma or allergies in acute forms;
• intolerance to contrast agent or iodine;
• severe renal, liver and heart failure;

How to prepare for a chest CT scan

Before the patient, on a special tomograph table, goes directly into the apparatus tunnel under the influence of X-rays, the doctor conducts a survey, during which he finds out whether there are contraindications to this type of examination, and whether the person suffers from allergies of any etiology. If the patient has the results of previous studies and previous tests, they must be provided to the doctor for study.

If the procedure is planned without the introduction of a contrast agent, it does not require any special preparation. Otherwise, the doctor will ask you to do a blood test for creatinine in advance. You should not consume food or drinks 2-4 hours before the examination.

If scanning with contrast is necessary, a special iodine-based drug is administered to the patient intravenously. To do this, a syringe or catheter with an automatic injector is used, which passes the substance at a certain speed. After administration of an iodine-containing drug, the patient may feel fever, burning, nausea, a rush of blood to the head, and increased blood pressure.

Before the procedure begins, all metal objects, jewelry, and devices must be removed and left outside the room with the tomograph.

The examination takes place directly inside the tomograph. The subject is placed on the retractable table of the tomograph, where he is most conveniently located. It must be taken into account that moving during the scan is prohibited, so the posture should be relaxed and natural.

The table together with the patient is pushed into the space of the device. The person is there alone, but the doctor is watching him from the next room and can communicate with him. During the tomography, the doctor periodically asks you to hold your breath for a while.

The total duration of the procedure varies from 15 to 30 minutes. If it was carried out with contrast, after its completion the patient is recommended to drink plenty of fluids so that the drug is quickly eliminated from the body. Unpleasant symptoms that may appear due to tomography usually disappear within 24 hours.

Who interprets the examination results and how?

The interpretation of the data and the conclusion on them is issued by a radiologist. This medical document will then be the subject of study by doctors of various specialties who can refer for such a study: cardiologist, thoracic surgeon, therapist, pulmonologist, oncologist, etc.

By studying the image displayed by the tomograph on the monitor, the radiologist assesses the condition of the internal organ systems in the chest and their tissues. In this case, organs and tissues can be examined in different planes, since the image is formed layer by layer, in thin sections.

In conclusion, the radiologist describes the localization of the pathology, the stage of its development, and the features of the course reflected in the images. Based on these data, the attending physician will further develop treatment tactics.

Benefits and possible risks of CT scanning

The advantages of computed tomography over other examination methods are described by doctors and biologists. This technique is non-invasive, so the likelihood of complications after it is extremely low.

Patients who have undergone a tomograph scan note that they do not feel pain or discomfort during the process; the only thing that is required of them is to lie quietly on the table, sometimes holding their breath. Special computer equipment technologies make it possible to obtain a very accurate image with detailed localization of all lesions of the chest organs.

In addition, the procedure itself takes only 15-30 minutes, and if acute bleeding or injuries are detected, their fastest detection allows immediate treatment to begin.

Regarding risks and complications, doctors usually name two main factors that can harm a person’s health as a result of a CT scan. The first of these is the danger of x-ray exposure.

However, if the frequency of the procedure does not exceed twice a year, no problems should arise. The second factor relates to tomography with contrast.

It is known that a contrast agent can cause acute allergic reactions in patients, so the doctor’s task is to reduce this probability to zero, or provide emergency assistance if an allergy attack does occur.

Multislice computed tomography is the result of decades of development by technicians, engineers, physicists, mathematicians and physicians.

Tomography scanning can detect hidden diseases that are not detected during other types of examinations.

Tedeeva Madina Elkanovna

Specialty: therapist, radiologist.

Total experience: 20 years.

Place of work: SL Medical Group LLC, Maykop.

Education: 1990-1996, North Ossetian State Medical Academy.

Training:

1. In 2016, at the Russian Medical Academy of Postgraduate Education, she underwent advanced training in the additional professional program “Therapy” and was admitted to carry out medical or pharmaceutical activities in the specialty of therapy.

2. In 2017, by the decision of the examination commission at the private institution of additional professional education “Institute for Advanced Training of Medical Personnel”, she was admitted to carry out medical or pharmaceutical activities in the specialty of radiology.

Work experience: therapist – 18 years, radiologist – 2 years.

Source: https://FoodandHealth.ru/diagnostika/kt-organov-grudnoy-kletki/

Chest CT

Computed tomography (CT) of the chest is a study that is performed by scanning the tissues and internal organs of the chest with X-ray radiation.

The detail of the resulting images allows you to detect even minor deviations from the norm. Therefore, CT of the chest is often prescribed to diagnose hidden pathologies, for example, malignant neoplasms in the lungs and metastases in the lymph nodes.

Indications for chest CT

Chest CT allows you to determine the course and nature of the disease in almost any organs and tissues located in the chest. Indications for CT are:

• the occurrence of various types of pain in the chest area;
• chronic (for a long time) cough, difficulty breathing, shortness of breath;
• partial or complete blocking of movements in the spine or shoulder girdle;
• preparation for surgery or radiotherapy (irradiation);
• diagnosis of inflammatory processes in the respiratory system;
• various chest injuries;
• developmental anomalies, pathologies of the heart, aorta, mediastinum;
• infectious diseases, such as pulmonary tuberculosis or pneumonia;
• suspicion of chest cancer;
• inability to make an accurate diagnosis using other research methods.

A CT scan can be prescribed by the attending physician after a preliminary examination of the patient, collection of anamnesis data (life history and illness), including allergological data.

Contraindications

Contraindications to CT are identified even before the examination, during an objective assessment of the patient’s health status. It can be:

• pregnancy at any stage - exposure to x-rays negatively affects the intrauterine development of the child;
• allergy to iodine for CT with contrast;
• diabetes mellitus, renal failure, thyroid pathologies, multiple myeloma; in these diseases, a contrast agent is strictly prohibited, since it can provoke an exacerbation of the disease and lead to serious consequences;
• claustrophobia (fear of closed spaces) interferes with being in a CT scanner, provoking panic in the patient;
• mental disorders – can cause an inadequate response of the patient to the manipulations;
• muscle spasms, convulsions, hyperkinesis - the inability to control one’s own body movements makes it impossible to carry out the procedure;
• weight more than 150 kg - the device is not designed for heavy loads;
• the presence of barium suspension in the digestive system after a recent examination of the abdominal cavity may affect the quality of the images.

Preparing for the study

Immediately before a computed tomography scan, a preventive conversation is held with the patient. The doctor talks about the possible risks of CT scanning, the course of the examination, the patient’s tactics during the procedure and the expected results.

No special preparation is required on the part of the patient for CT without contrast.

The contrast agent is administered strictly on an empty stomach (at least 4 hours before the examination, the subject is prohibited from eating or drinking any liquid).

How is a chest CT scan performed?

The duration of the procedure is from 10 minutes to 1 hour (CT with contrast takes longer). Before the examination begins, the doctor asks the patient questions about his state of health, the presence of chronic diseases and allergic reactions. This is necessary in order to once again ensure that the patient has no contraindications to the procedure. The doctor also gets acquainted with the results of previously performed examinations - by comparing these data and newly obtained information, it is possible to monitor the dynamics of the development of the disease. If a CT scan is performed with contrast, the drug is administered before the procedure begins.

During the scan, the subject lies on the diagnostic table inside the tomograph, which begins to smoothly rotate around the patient. This is how photography is done.

This action usually does not cause discomfort or discomfort in patients.

But in case of panic, feelings of fear or anxiety, or deterioration in health, at the request of the patient, the examination will be stopped, and he will be provided with specialized medical care.

Side effects

There are no obvious side effects with CT. Some patients report feeling nauseous and dizzy during the scan. Allergic reactions to contrast are rare because they are usually reported before the study begins.

Important! When performing a CT scan with contrast, breastfeeding mothers should stop breastfeeding for the next 48 hours. It is recommended to express milk (you should not give it to the baby), because the contrast agent enters not only the blood and urine, but also into the secretion of the mammary glands.

Research results

The CT report is given to the patient within 24 hours (usually after 2 hours); if necessary, it is passed on to the attending physician. According to the results, in which the radiologist indicates the identified disease, the localization of the pathology, the course of the disease or other abnormal processes, the attending physician selects the most effective therapeutic technique.

CT scans can confirm or reveal:

• vascular diseases;
• lung cancer, emphysema, bronchiectasis, pneumonia, tuberculosis;
• pathologies of the heart, aorta, mediastinum;
• metastases affecting nearby organs, bone marrow, spine;
• accumulation of fluid in the pleural cavity;
• causes of cardiac muscle dysfunction, aortic dissection;
• anomalies of the skeletal structure, etc.

Alternative research methods

Computed tomography has several advantages over traditional research methods:

• CT images visualize the organ in any projection (3D image), unlike ultrasound, where the image is displayed in one plane;
• the ability to recognize organs and tissues whose differences in structure are less than 1%;
• layer-by-layer scanning allows you to identify tumors of the smallest size, which is completely impossible with radiography;
• The low dose of radiation makes CT safer than radiography.

Chest CT is more informative for studying bone tissue, as it has high sensitivity to dense structures, unlike MRI and other types of diagnostics.

When examining the chest organs, doctors give greater preference to computed tomography, because this procedure perfectly visualizes both bone tissue, organs, and blood vessels. In addition, patients themselves are more often inclined to CT - this examination is an order of magnitude cheaper than magnetic resonance imaging (MRI).

Source: https://www.diagnos.ru/procedures/manipulation/kt/kt-grud

Chest CT

Below in the article there is information about what the study is, who is indicated and contraindicated, what opportunities it opens up, and how it is carried out. A brief comparative description with other diagnostic methods is also made.

About the essence of the study

Computed tomography of the chest in medical terminology is hidden behind the abbreviation CT OGK. The method involves the use of X-ray radiation produced by a special device - a tomograph.

The rays penetrate the human body, causing one reaction or another. The sensors “catch” the tissue response and reformat it into a two-dimensional or three-dimensional detailed image that is displayed on a screen. The doctor, analyzing the image, has the opportunity to draw conclusions about the condition of the examined organ.

Chest CT, like other types of computed tomography, is a non-invasive method, that is, it does not require mechanical penetration into the body, and this is a huge plus.

Also among the advantages is the highest information content. The reliability of the image is about 98%. However, CT has certain limitations. The method is most effective when examining hard tissues, that is, bones. Soft ones are best studied using MRI, but there are exceptions.

Types of computed tomography of the chest

Like all other types of CT scans, chest tomography can be standard (using X-rays only) or with contrast. The second type is considered more informative. It involves the introduction of a special substance with tinting properties into the patient’s blood.

The latter impregnates the examined tissues, making the image contrasting. It makes it easier to see pathologies. Chest CT with contrast is prescribed in complex, controversial situations when conventional tomography does not provide an accurate answer to the doctor’s questions. In addition, computed tomography is divided into:

• Spiral, when sensors placed in one row rotate in curls.
• Multilayer (multispiral). The sensors also rotate in a spiral, but are placed in several rows, which gives a more detailed image.

The doctor decides which type of diagnostics will be used in a particular case.

What research can reveal

Computed tomography is usually prescribed when other, simpler methods have not provided comprehensive information. The list of dysfunctions that can be detected during a chest CT scan is very wide:

• consequences of injuries to the ribs or spine (cracks, bruises);
• osteochondrosis of the thoracic spine;
• pathological processes in the heart muscle and aorta;
• mediastinal abnormalities;
• oncological and benign tumors in the lungs;
• metastases in the spine;
• vascular dysfunction;
• the presence of fluid in the pleura;
• emphysema;
• esophageal stenosis;
• infectious lesions of the respiratory system;
• hernias in the diaphragm or spinal column;
• pathological processes in the mammary glands in women;
• anomalies of lymph nodes localized in the examined area.

Computed tomography can detect even minimal deviations from the norm. The doctor has the opportunity to make an accurate diagnosis at the embryonic stage of development of a particular disease. This significantly improves treatment prognoses.

List of indications

From the list above, we can conclude who needs a chest computed tomography scan. These are people who are suspected of having serious lesions:

• hearts;
• lungs;
• ribs;
• spine;
• mammary glands.

The method is also used when a foreign body enters the respiratory system or esophagus. Indications for CT scanning may include the following conditions:

• pain in the chest area;
• persistent cough for a long time;
• breathing problems;
• stiffness of movement of the shoulder girdle or in the thoracic spine;
• tingling in the hands, their numbness;
• dyspnea.

Computed tomography is mandatory for cancer patients before starting a course of chemotherapy or radiation, and for patients with cancer and other pathologies on the eve of surgery. Further, the condition of such people is monitored using CT.

Who should not undergo a CT scan?

Computed tomography is a safe method, but only relatively. However, it involves the use of X-rays, which tend to accumulate in the body and cause some harm to it. Although the radiation dose from CT is small, there are contraindications to the use of the method. Among them:

• “interesting” situation for women;
• breastfeeding period;
• critical condition of the patient, extreme weakness of the body.

Relative contraindications to chest CT are:

• children's age (up to fourteen years);
• the patient’s weight is more than 120 kg (most tomographs are simply not designed for such a weight);
• claustrophobia (if the tomograph is closed);
• nervous and mental disorders in which a person cannot remain still (and this is mandatory during the study).

Special attention should be paid to CT scans of the chest with contrast. When it is used, the list of “taboos” expands.

Such a study cannot be carried out for people with serious liver and kidney problems (in particular, failure of these organs), allergies to the dye, or myeloma.

The list of prohibitions includes patients with diabetes mellitus and some other endocrine diseases and serious heart pathologies.

Preparation and progress of the procedure

If a routine CT scan of the chest is planned, no preparation on the part of the patient is required. You just need to prepare yourself mentally and come to the procedure on time with a referral from the doctor. If you have previously had a CT scan, you must take the previous images with you.

Tomography with contrast is performed on an empty stomach. The last meal should be no later than four hours before the procedure. This is what preparation is all about.

Before the examination, the patient dresses in loose clothing brought with him or provided at the clinic and lies down on a mobile table. If we are talking about contrast CT, a special substance is injected into the person’s blood.

The chest CT procedure takes from ten minutes to an hour, depending on the task and the complexity of the situation. The patient does not experience any discomfort during it. Results are usually ready the next day. The attending physician deciphers them.

Frequency of the procedure and possible harm

During a chest CT scan, a person receives a radiation dose that is twice the permissible annual background dose.

This information looks scary, but experts say that the study does not cause harm to the body if the examination is not carried out frequently.

Ideally, the interval should be 12 months (in the most extreme cases, six months). Failure to comply with this requirement may result in radiation sickness.

Some patients who have undergone diagnosis complain of headache, general weakness, and nausea afterwards. Such symptoms may indeed occur, but they quickly disappear on their own.

This response of the body to radiation is considered a variant of the norm.

Carrying out a CT scan of the chest with contrast can cause mild disorders of the gastrointestinal tract, which are also fleeting and can be eliminated without problems.

Despite the fact that CT is not absolutely safe, like MRI or ultrasound, it can still be considered a harmless method. In addition, in many cases this method is irreplaceable.

Neither ultrasound nor MRI can examine hard tissue as well as computed tomography. Its analogue is radiography. However, the capabilities of the latter are much smaller and the information content is lower. In this case, the patient receives the same amount of radiation, if not more.

Source: https://medsins.ru/kt/kt-grudnoj-kletki.html

Chest CT: indications, procedure, contraindications

Computed tomography is a method of radiation neuroimaging based on scanning the human body with X-rays.

The equipment contains one (linear tomographs) or several pairs of source-receiver complexes.

Multispiral (MSCT) devices have dozens of paired scanning systems that allow you to quickly scan and reduce a person’s radiation dose.

The technical part is represented by a table for placing the patient in the form of a closed tunnel. The person moves horizontally during the procedure. The spirals move a specified number of millimeters.

During one tomography of an organ, hundreds of sections are obtained. Images are processed by software supplied with the equipment.

The software allows you to process tomograms and build three-dimensional (3D) models of the area under study.

Disadvantages of CT scan of the lungs:

1. Ionizing radiation of the patient;
2. Low clarity of visualization of soft tissues;
3. Closed diagnostic tunnel (inconvenient for people with claustrophobia).

Advantages of computed tomography of the lungs:

1. High resolution;
2. Verification of tumors with a diameter of several millimeters;
3. Examination of questionable shadows after radiography;
4. Fast and informative;
5. Does not require complex preliminary preparation.

Due to radiation, examinations are prescribed strictly according to indications. CT scans are not performed without a doctor’s order!

It is convenient to compare the functioning of a computed tomograph with a cut loaf. Each slice is a slice. The collection of tomograms together constitutes a single image. Three-dimensional modeling shows the smallest changes in the structure of the bread inside. The technology makes it possible to study separately each “slice” or the structure of the organ as a whole.

Pulmonary dissemination on chest tomography

Preparing for a chest CT scan

No special preparatory procedures are required before the study. It is necessary to provide a referral from the attending physician and the results of other diagnostic methods.

Before tomography with contrast, it is necessary to exclude an allergy to iodine or renal failure, which can cause severe complications after enhancement with contrast agents.

If you need to see blood vessels during a tomography, a dose of contrast agent is first administered intravenously. The substance is distributed throughout the blood supply system, showing the walls, structures, and the direction of the arteries and veins. The spatial orientation and location of the vessel inside the organ under study is helped by the 3D modeling mode.

Indications for CT scan of the lungs

At the request of the person, computed tomography of the pulmonary system is not prescribed. The referral is given by a neurologist, therapist, pulmonologist, traumatologist.

Medical doctors preliminarily assess the patient’s health status, test results, and clinical and instrumental studies.

If contraindications are identified, the diagnostician has the right to refuse to perform a computed tomography scan due to the high risk of harm to health.

Indications for CT scan of the chest organs:

• Chronic diseases of the upper respiratory tract without the effectiveness of conservative treatment (shortness of breath, difficulty breathing, hacking cough);
• Preparation before radiation therapy of tumors of the lungs and mediastinum;
• Unexplained chest pain;
• Traumatic injuries;
• Anomalies in the structure of the organs of the mediastinum, aorta, lungs;
• Detection of inflammatory processes;
• Determination of oncological formations;
• Assessment of the course of chronic infections (tuberculosis, pneumonia);
• Difficulty making an accurate diagnosis.

Before contrast scanning, be sure to collect an allergy history to exclude unexpected reactions to iodine!

Contraindications to computed tomography of the lungs

Limitations to the procedure arise due to ionizing radiation of organs. The pulmonary system consists of soft tissues that are prone to mutations. Tomography should not be performed on children under fourteen years of age without strictly analyzing the indications and contraindications.

Only when the information content of the study significantly exceeds the harm, is there a need for a computed tomography scan for the child. The condition is met only when pathology cannot be established using alternative non-radiation diagnostic methods.

Contraindications to lung tomography:

• Pregnancy;
• Children under 14 years of age (only for strict indications);
• Kidney failure;
• Patients with chronic diseases of the thyroid gland and kidneys;
• Severe forms of diabetes mellitus;
• Allergic reactions to seafood and iodine;
• Multiple myeloma;
• Patients with twitching of certain muscle groups;
• Mental illnesses;
• Previous x-ray examination with barium injection;
• Limitations of computed tomographs based on human weight (on average no more than 150 kg).

Individual contraindications for the examination are determined by the attending physician. The specialist identifies possible complications and predicts the possibility of performing tomography.

Progress and duration of the computed tomography procedure

The duration of the CT scan is determined by the area of ​​study. Multispiral CT of the lungs (MSCT) lasts about five minutes. If a procedure with contrast is required, the interval is extended to twenty minutes. The duration is determined by the interval of injection of the drug, observation of the passage of the substance through the vessels.

The need for contrast may arise during the initial examination of the chest cavity if the specialist detects additional foci that require verification. For example, small tumors are not clearly visible on tomograms. After administration of an iodine-containing compound, the nature of the blood supply to the tumor node can be monitored.

To quickly relieve complications of contrast CT studies, radiology rooms are equipped with emergency first aid kits. State medical institutions have intensive care units that provide assistance in life-threatening situations.

If contrast injection is planned, a flexible catheter is first installed in the patient's antecubital vein. When passing the drug, a person feels heat, warmth, and a metallic taste in the mouth.

The duration of the sensation is one to two minutes. A few minutes after the procedure, a person may feel the urge to urinate, which is associated with the contrast drug reaching the kidneys.

The effect quickly wears off on its own.

When a baby is scanned, parents are given a lead apron for protection. The office is equipped with a communication system with staff, so any complications must be reported to the staff immediately. The clicking and buzzing sounds of the device are natural operation of the equipment.

Side effects of CT scanning

Complications after the procedure are rare. List of CT complications:

• Dizziness;
• Nausea and vomiting;
• Allergic reactions;
• Dizziness;
• Indigestion;
• Increased pressure;
• Dyspnea;
• Metallic taste in the mouth.

Side effects after a CT scan are rare, but you need to be aware of the possibility of them occurring.

Features of CT scan of the lungs with contrast

The enhancement agent procedure complements the native scan. Always performed after native tomography.

Is CT scanning dangerous?

Human radiation exposure is dangerous when the exposure dose is exceeded. Every year a person receives about 2000 mSv of ionizing radiation from the background of the planet. Gradual action poses no threat.

The human body is able to eliminate the negative effects of small doses. The influence of high levels of radiation leads to tissue damage.

If acute radiation sickness develops, irreversible organ damage occurs.

The progression of the tumor is deadly, so it is necessary to stop the disease by any means. Radical treatment of cancer is only possible if it is detected at the beginning of its development.

Using computed tomography, it is possible to detect tumors of the lungs and mediastinum measuring several millimeters in size.

Interpretation of CT results

The duration of obtaining a description and conclusion after the study can be several minutes or hours. The timing depends on the workload of the radiologist. Analysis of hundreds of tomograms, the need to perform repeated contrast scanning slows down the interpretation of the results.

To eliminate the factor of long waits for descriptions at the walls of the radiation specialist’s office, private clinics offer the service “sending images and tomography results by e-mail.” If there is no urgency, it is convenient to use the offer.

State institutions are deprived of modern facilities. Recording to a disc is often done only after the optical media has been provided or payment has been made from the health insurance company.

There are hundreds of computed tomograms of the chest cavity per examination procedure. The better the tomograph, the more images are obtained. To get a lot of pictures you need a large box.

The size often exceeds 30 MB.

The information content of deciphering the results does not always satisfy the attending physicians. If the images are recorded on disk, you can use the “alternative opinion” service.

Radiologists at some commercial and government centers offer the opportunity to analyze CT and MRI scans taken at other medical institutions.

Choose a highly qualified specialist, based on customer reviews.

By choosing an institution with a modern multislice tomograph, but a low-qualified radiologist, you can save money if a high-quality result is not needed immediately. Sometimes the attending physician, having received a description and conclusion of a CT scan of the chest organs, cannot correctly draw up a treatment plan. An alternative opinion helps eliminate difficulties.

What does a CT scan of the lungs show:

1. Pneumonic foci;
2. Tuberculosis;
3. Bronchiectasis;
4. Emphysema;
5. Cancer;
6. Vascular diseases;
7. Accumulation of fluid in the pleural cavity (pleurisy);
8. Metastases from the mammary glands, spine, bone marrow;
9. Anomalies of the osteoarticular system;
10. Aortic dissection, aneurysm;
11. Diseases of the aorta, pulmonary artery (contrast study).

Improved technology improves research efficiency. An increase in the number of spirals in modern multispiral tomographs makes it possible to detect the smallest pathological formations.

Advantages of CT over other methods:

• Detection of even minor changes in distinguishable tissues (detects changes in 1%);
• Creating a three-dimensional model (3D picture) allows you to study the spatial structure of the organ;
• Detection of small oncological formations using MSCT and contrast;
• Small dose of radiation during multislice tomography of the chest cavity.

In conclusion, let us recall that computed tomography better shows changes in hard tissues (osseous and joint system), but allows us to study organs with sharp air-soft tissue interfaces (lungs).

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Source: https://mrt-kt-legkih.ru/article/kt-grudnoy-kletki