CT scanning—sometimes called CAT scanning—is a noninvasive,
painless medical test that helps physicians diagnose and
treat medical conditions.
CT imaging uses special x-ray equipment to produce multiple
images or pictures of the inside of the body and a computer
to join them together in cross-sectional views of the area
being studied. The images can then be examined on a computer
monitor or printed.
CT scans of internal organs, bone, soft tissue and blood
vessels provide greater clarity than conventional x-ray
exams.
Using CT, the bony structure of the spinal vertebrae is
clearly and accurately shown by CT scanning, as are the
intervertebral disks and, to some degree, the spinal cord.
Perhaps the most frequent use of spinal CT is to detect—or
rule out—spinal column damage in patients who have been
injured.
CT scanning of the spine is also performed to:
- evaluate the spine before and after surgery.
- detect various types of tumor in the vertebral column,
including those that have spread there from another area
of the body. Some tumors that arise elsewhere are first
identified by finding deposits of malignant cells (metastases)
in the vertebrae; prostate cancer is an example.
- help diagnose spinal pain. One of the most common causes
of spinal pain that may be diagnosed by CT is a herniated
intervertebral disk, sometime with CT myelography
- accurately measure bone density in the spine and predict
whether vertebral fractures are likely to occur in patients
who are at risk of osteoporosis.
- guide diagnostic procedures such as the biopsy of a
suspicious area to detect cancer, or the removal of fluid
from a localized infection (abscess).
In patients with narrowing of the spinal canal, vertebral
fracture, infection or degenerative disease such as arthritis,
CT of the spine may provide important information when
performed alone or in addition to magnetic resonance imaging
(MRI).
You should wear comfortable, loose-fitting clothing to
your exam. You may be given a gown to wear during the procedure.
Metal objects including jewelry, eyeglasses, dentures and
hairpins may affect the CT images and should be left at
home or removed prior to your exam. You may also be asked
to remove hearing aids and removable dental work.
You may be asked not to eat or drink anything for several
hours beforehand, especially if a contrast material will
be used in your exam. You should inform your physician
of any medications you are taking and if you have any allergies,
especially to contrast materials.
Also inform your doctor of any recent illnesses or other
medical conditions, and if you have a history of heart
disease, asthma, diabetes, kidney disease or thyroid problems.
Any of these conditions may increase the risk of an unusual
adverse effect.
Women should always inform their physician or technologist
if there is any possibility that they are pregnant.
If your infant or young child is having a spinal CT, there
are measures that can be taken to ensure that the test
will not be a cause of anxiety for either the child or
parent.
The CT scanner is typically a large machine with a hole,
or tunnel, in the center. A moveable examination table
slides into and out of this tunnel. In the center of the
machine, the x-ray tube and electronic x-ray detectors
are located opposite each other on a ring, called a gantry,
which rotates around you. The computer that processes the
imaging information and monitor are located in a separate
room.
In many ways CT scanning works very much like other x-ray
examinations. X-rays are a form of radiation—like light
or radio waves—that can be directed at the body. Different
body parts absorb the x-rays in varying degrees.
In a conventional x-ray exam, a small burst of radiation
is aimed at and passes through the body, recording an image
on photographic film or a special image recording plate.
Bones appear white on the x-ray; soft tissue shows up in
shades of gray and air appears black.
With CT scanning, numerous x-ray beams and a set of electronic
x-ray detectors rotate around you, measuring the amount
of radiation being absorbed throughout your body. At the
same time, the examination table is moving through the
scanner, so that the x-ray beam follows a spiral path.
A special computer program processes this series of pictures,
or slices of your body, to create two-dimensional cross-sectional
images, which are then displayed on a monitor.
CT imaging is sometimes compared to looking into a loaf
of bread by cutting the loaf into thin slices. When the
image slices are reassembled by computer software, the
result is a very detailed multidimensional view of the
body's interior.
Refinements in detector technology allow new CT scanners
to obtain multiple slices in a single rotation. These scanners,
called "multislice CT" or "multidetector
CT," allow thinner slices to be obtained in a shorter
period of time, resulting in more detail and additional
view capability.
Modern CT scanners are so fast that they can scan through
large sections of the body in just a few seconds. Such
speed is beneficial for all patients but especially children,
the elderly and critically ill.
For some CT exams, a contrast material is used to enhance
visibility in the area of the body being studied.
The technologist begins by positioning you on the CT examination
table, usually lying flat on your back or possibly on your
side or on your stomach. Straps and pillows may be used
to help you maintain the correct position and to hold still
during the exam.
If a contrast material is used, it will be injected through
an intravenous line (IV) into an arm vein during the procedure.
A scan of the lower spine may also be done after injecting
contrast material into the spinal canal (usually well below
the bottom of the spinal cord) during a lumbar puncture.
This will help to detect tumors or locate areas of inflammation
or nerve compression.
Next, the table will move quickly through the scanner to
determine the correct starting position for the scans.
Then, the table will move slowly through the machine as
the actual CT scanning is performed.
You may be asked to hold your breath during the scanning.
When the examination is completed, you will be asked to
wait until the technologist determines that the images
are of high enough quality for the radiologist to read.
The CT scanning is usually completed within 30 minutes.
What will I experience during and after the procedure?
Most CT exams are painless, fast and easy. With spiral
CT, the amount of time that the patient needs to lie still
is reduced.
Though the scanning itself causes no pain, there may be
some discomfort from having to remain still for several
minutes. If you have a hard time staying still, are claustrophobic
or have chronic pain, you may find a CT exam to be stressful.
The technologist or nurse may offer you a mild sedative
to help.
If an intravenous contrast material is used, you will feel
a slight pin prick when the needle is inserted into your
vein. You may have a warm, flushed sensation during the
injection of the contrast materials and a metallic taste
in your mouth that lasts for a few minutes. Occasionally,
a patient will develop itching and hives, which can be
relieved with medication. If you become light-headed or
experience difficulty breathing, you should notify the
technologist or nurse, as it may indicate a more severe
allergic reaction.
When you enter the CT scanner, special lights may be used
to ensure that you are properly positioned. With modern
CT scanners, you will hear only slight buzzing, clicking
and whirring sounds as the CT scanner revolves around you
during the imaging process.
You will be alone in the exam room during the CT scan,
however, the technologist will be able to see, hear and
speak with you at all times.
With pediatric patients, a parent may be allowed in the
room but will be required to wear a lead apron to prevent
radiation exposure.
After a CT exam, you can return to your normal activities.
If you received a contrast material, you may be given special
instructions.
A radiologist, a physician specifically trained to supervise
and interpret radiology examinations, will analyze the
images and send a signed report to your primary care or
referring physician, who will share the results with you.
Benefits
- Spinal CT scanning is a rapid procedure and offers
an accurate evaluation of bone and most soft tissues.
Using the latest equipment, the spine may be displayed
in multiple planes and three-dimensional imaging is an
option.
- CT scanning is painless, noninvasive and accurate.
- A major advantage of CT is that it is able to image
bone, soft tissue and blood vessels all at the same time.
- Unlike conventional x-rays, CT scanning provides very
detailed images of many types of tissue as well as the
lungs, bones, and blood vessels.
- CT examinations are fast and simple; in emergency cases,
they can reveal internal injuries and bleeding quickly
enough to help save lives.
- CT has been shown to be a cost-effective imaging tool
for a wide range of clinical problems.
- CT may be less expensive than MRI. In addition, it
is less sensitive to patient movement.
- CT can be performed if you have an implanted medical
device of any kind, unlike MRI.
- CT imaging provides real-time imaging, making it a
good tool for guiding minimally invasive procedures such
as needle biopsies and needle aspirations of many areas
of the body, particularly the lungs, abdomen, pelvis
and bones.
- A diagnosis determined by CT scanning may eliminate
the need for exploratory surgery and surgical biopsy.
- No radiation remains in a patient's body after a CT
examination.
- X-rays used in CT scans usually have no side effects.
Risks
- There is always a slight chance of cancer from radiation.
However, the benefit of an accurate diagnosis far outweighs
the risk.
- The effective radiation dose from this procedure is
about 10 mSv, which is about the same as the average
person receives from background radiation in three years.
- Women should always inform their physician or x-ray
technologist if there is any possibility that they are
pregnant.
- CT scanning is, in general, not recommended for pregnant
women because of potential risk to the baby.
- Nursing mothers should wait for 24 hours after contrast
material injection before resuming breast-feeding.
- The risk of serious allergic reaction to contrast materials
that contain iodine is rare, and radiology departments
are well-equipped to deal with them.
- Children should have a CT study only if it is essential
for making a diagnosis and should not have repeated CT
studies unless absolutely necessary.
A person who is very obese may not fit into the opening
of a conventional CT unit.
Spinal CT does not consistently show enough detail to properly
assess the spinal cord. MRI is also more suitable than
CT for demonstrating injured ligaments, the status of the
intervertebral disks and hematomas in the area of the spine.
CT scanning fails to identify some vertebral fractures
that are not displaced.
Reference:
http://www.radiologyinfo.org/
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Diagnostics 
