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Types of CT

Computed tomography is a relatively new diagnostic method, however, despite its relative youth, the technology of tomographic examination, the method of interpreting results, and most importantly the diagnostic equipment itself have undergone significant improvements.

According to the decision of the attending physician, based on objective indications, the patient may be offered one of four types of tomographic examination. Despite the fact that all diagnostic techniques have significant differences, they are united by the operating principle of the tomograph.

Spiral computed tomography

The first safe method of tomographic examination was the method of spiral computed tomography. This technique has been tested in practice many times and is considered the most informative. This method received its name because of a specific examination procedure, during which the radiation source and the table with the patient rotate in a spiral relative to each other. During the entire procedure, the patient, located on a special table, is scanned using a source of directed x-ray radiation, obtaining an accurate layer-by-layer picture of the area of interest. During scanning, the coverage area continuously increases, and the duration of the examination decreases.

Multislice computed tomography

The next computed tomography method is a logical development of the previous one. Due to the specificity of the effects of X-ray radiation, it was called multislice computed tomography; in addition, it is also called multislice and multilayer. In this type of tomography, X-rays passing through the area under study are captured by an ultrasensitive detector, thereby forming an image of the object of interest. The radiation is directed not in a fan-shaped manner (as with the spiral method), but in a volumetric manner, which allows not only to study a large area, but also to significantly reduce the received radiation dose. The advantage of this method is the possibility of simultaneous use of several radiation tubes, which significantly reduces the procedure time, without significantly increasing the radiation dose to the body. It is logical to conclude that this type of computed tomography is potentially less dangerous than all others.

Cone beam computed tomography

The next method is used exclusively in maxillofacial surgery and is called cone beam computed tomography. Its main difference from the previous ones is the design of the tomograph, the ring of which differs from other versions in size (lower than in previous versions) and location (the ring is located strictly vertically, presumably at head level). The patient's head is placed inside the ring part of the tomograph, around which the beam tube rotates. This diagnostic method allows you to obtain three-dimensional contrast images of teeth and skull bones, making it possible to detect pathology even at the initial stages of its occurrence.

Emission computed tomography

The next method is emission computed tomography. It is used in exceptional cases and is carried out only in those diagnostic centers that have special equipment and appropriate permission to work with radioactive pharmacological drugs. The main feature of this method is that to carry out diagnostics, a drug containing a special solution of radionuclides that accumulate in tissues and organs is injected into the patient’s body, making them clearly visible in the photographs. Most often, emission tomography is used to identify severe systemic pathologies that cannot be detected by other diagnostic methods. Emission tomography is only in its infancy, however, its scope of application is growing every year. Modern medicine uses emission CT in diagnosing cancer, pathologies of the brain and the cardiovascular system.

In modern medical practice, multilayer or spiral types of computed tomography are most often used.

Is MSCT harmful to a child and is MSCT dangerous during pregnancy?

Children are especially susceptible to radiation exposure (and with MSCT, the radiation dose can reach up to 12 mSv versus 0.5 mSv with conventional radiography), they have a greater risk of developing cancer. This happens because the tissues of a child’s (and even more so the unborn) body are in a phase of continuous growth, and, therefore, are more susceptible to DNA changes. Also, the chance of developing a tumor after MSCT is much higher in a child than in an adult, because there is actually more time for a tumor to develop in children than in adults and the elderly. To reduce the risk of consequences, it is highly not recommended to perform MSCT on children until the process of active tissue growth has completed (up to 14 years). During pregnancy, MSCT is an absolute contraindication and can be performed only if there is an absolute risk to life and it is impossible to urgently perform an alternative non-ionizing scan (MR imaging).

Why do a CT scan?

The list of indications for tomography is quite extensive, however, in addition to suspicion of the presence of diseases, it makes sense to conduct a computed tomography scan if the attending physician has doubts about the correctness of the diagnosis.

Recently, it has become fashionable to undergo a CT scan to assess the condition of the whole body. This is reasonable if the patient has sufficient financial resources and some free time. However, some experts are very critical of this approach, arguing with the following statements:

Tomography is not always able to detect existing diseases, since there are some individual characteristics that limit visualization.

CT scan of the whole body (regardless of the chosen diagnostic technique) is a very expensive undertaking.

This type of study makes sense to prescribe if there is an immediate threat to the health and life of the patient.

From the standpoint of safety and economy, it makes sense to conduct research only on those organs whose normal functioning is in doubt. Also, if they are at risk for any chronic diseases.

Several types of diagnostics can be used simultaneously (ultrasound, MRI, laboratory tests).

Most often, computed tomography of the following organs is performed:

bones, muscles, ligaments and joints;
internal organs;
heart and blood vessels.

How does CT differ from MRI?

Many people, especially those encountering computed tomography for the first time, are trying to understand: what is better than CT or MRI?; What is the difference between CT and MRI? And which method will be more effective in their case.

To answer the question: what is the difference between MRI and CT? — one should understand the mechanisms of their influence and areas of use. For example, if in computed tomography a directed beam of X-ray radiation is used to obtain an image, then in MRI the principle of nuclear magnetic resonance is used for the same purposes.

It is worth noting that although in some cases (especially when it is necessary to obtain images of blood vessels or the spinal cord), MRI is superior in efficiency to CT, it can also cause more serious harm to the patient’s body. Therefore, the decision regarding its use can only be made by a qualified physician, after a thorough assessment of all risks.

MSCT or CT - which is better?

Without a doubt, MSCT is the priority type of scanning among all types of computed tomography. Step CT is bad because the slice thickness is at least 10 cm, which is why a large number of pathologies simply do not fall into the scanning area, which is especially important when identifying metastases, strokes, and small focal formations. In addition, long-term scanning with a stepper inevitably led to motion artifacts, especially when scanning the lungs, since it is impossible to hold your breath for a long time.

Due to the short scanning time, the MSCT device allows one to avoid such artifacts, and the lungs are now examined in just one breath-hold. The introduction of ECG synchronization, in which a slice is made only between heart contractions, as well as the use of a contrast agent, made it possible to examine in detail the heart, aorta and other “pulsating” vessels. The main thing is that high spatial resolution has been achieved with the ability to scan in any plane with the construction of three-dimensional images, which allowed the MSCT device to show oncology with an accuracy of 0.5 mm, examine even the smallest metastases and identify the extent of the process.

If we take into account the same number of slices for stepwise CT and MSCT, then with MSCT the radiation dose will be significantly lower. However, MSCT allows one to examine thin sections, and their number during scanning can reach several thousand, which undoubtedly ultimately increases the radiation dose. Therefore, unreasonable multiphase scanning and reduction of slice thickness is unacceptable.

Is the computer examination procedure safe?

There is an opinion based on the assumption of the potential harm that X-rays used in the research process can cause. Note that although these fears are completely unfounded, they encourage many potential patients to abandon CT in favor of MRI. A use that is completely unjustified.

Thanks to the use of the latest technologies and radioactive materials in modern tomographs, the radiation dose is much lower than when using an X-ray machine. Of course, one should not think that minimal radiation is absolutely safe, but it can be argued that the use of CT will not cause much damage (even if it is used repeatedly).

Only a qualified radiologist can determine the number of procedures that will not harm the patient’s health, based on the need for the study and the radiation dose previously received by the patient.

How many times can MSCT be done per year?

The answer to this question, how often an MSCT examination can be done, depends on the area being examined. For example, with MSC scanning of the head, the radiation dose is on average 1.4 mSv, for the chest and abdominal cavity - 2 times more, pelvis - 2.5 times more. The safe radiation dose for the population is 1 mSv per year (equivalent to two x-rays of the lungs), if necessary, it can be increased to 5 mSv per year. As you can see, the permissible number of studies for the head is 3 per year, for other areas - 1 time per year (all this taking into account the absence of other ionizing procedures). If research is still necessary, it is recommended to use a safe and equally high-precision imaging method - MRI (in the absence of contraindications).

Contraindications for computer diagnostics

The following contraindications exist for patients:

Pregnancy and lactation – despite the fact that the area of exposure to directed X-ray radiation is relatively small and the dose received by the patient is minimal, the procedure can damage the health of the fetus and significantly reduce the quality of breast milk.
Claustrophobia - due to the specifics of the study (the patient is placed in a confined space for the period of the study), patients with claustrophobia may develop nervousness and a panic attack. If no alternative is available, patients must be sedated prior to the procedure.
Renal pathologies - the introduction of a contrast agent required for CT scanning can provoke an exacerbation of existing kidney diseases.

Contraindications to MSCT

Contraindications for CT:

pregnancy at any stage of gestation;
not recommended for children under 14 years of age;
not recommended for existing multiple myeloma and recent ionization examinations;
excessive weight of the patient;
inability to take a supine position.

Contraindications for contrast enhancement:

uncompensated thyrotoxicosis;
history of severe reactions to an iodine-containing drug;
renal failure with a significant decrease in clearance;
with caution in severe bronchial asthma.

Contraindications for cardiac CT:

an irregular rhythm that cannot be made regular with medication (for example, a permanent form of atrial fibrillation);
inability to hold your breath for 15 seconds.

Why is contrast needed?

In some cases, if there are indications, the attending physician decides on the need to use specialized contrast agents. Contrast agents are a class of chemicals (iodinated) that accumulate in certain tissues.

Depending on the purpose of the procedure, the contrast agent is administered intravenously or through the oral cavity, and also in some (very rare cases) through the rectum.

In most cases, the contrast agent is cleared from the body within 3-7 days.

MSCT of the head: what is it, indications, preparation - MEDSI

What is MSCT for brain research?
MSCT of the head allows
How is MSCT performed?
Differences between MSCT and MRI
Contraindications and risks
Advantages of carrying out the procedure at MEDSI

MSCT (or CT)
– multislice computed tomography. A radiation diagnostic method that allows you to achieve highly detailed images of an organ.

What is MSCT for brain research?

MSCT of the brain is a multi-slice scan of brain structures. Depending on the settings of the tomograph, it can record both soft tissues of different densities (vessels, glands, brain tissue and meninges) and bone structures of the skull. The procedure lasts up to 20 minutes, depending on the purpose and scope of the study.

MSCT of the brain is prescribed:

If a stroke is suspected - in order to clarify the focus and extent of the lesion (ischemia, hemorrhage, hematoma)
For the diagnosis of neoplasms (cysts, tumors, infiltrates), their location and size
For obsessive headaches, dizziness, double vision and other meningeal symptoms of unknown origin - in order to clarify the diagnosis
If you have symptoms of increased intracranial pressure
When performing a biopsy of neoplasms of brain structures - for the purpose of better visualization, for greater accuracy of the procedure
After a head injury to assess the degree of damage to the brain and membranes, the presence of bleeding, foreign bodies
To assess the condition of blood vessels and the level of blood supply to the brain (for atherosclerosis, ischemia, aneurysm)

To study the condition of the vessels, a radiopaque substance is used, which makes it possible to trace the vessel along its entire length: to assess its integrity, filling, and patency. With the blood flow, it passes through the vessels, highlighting them in the picture. CT uses iodine-based drugs, which are then eliminated from the body by the kidneys.

Contraindications for the use of contrast:

Kidney failure
Continuous use of Metformin (for diabetics)
Intolerance to iodine-containing drugs
History of hypersensitivity reactions (anaphylactic shock, angioedema), asthma

MSCT devices administer a contrast agent as a bolus - automatically, in a strictly dosed mode. This method allows you to reduce the dose of the drug.

MSCT of the head allows:

examine the bone structures of the skull for microdamages, structural changes, metastases
examine the temporal bones in the presence of pathologies of the auditory or vestibular system
conduct an oncological search: determine the location of the tumor in the organ (if its presence is suspected) and diagnose small focal neoplasms up to 1 mm in size
monitor antitumor therapy
establish the causes of impairment or lack of consciousness
diagnose stroke, cerebral edema, intracranial bleeding, hematoma or hemorrhage, vascular disorders
assess the condition of the hypothalamic-pituitary system

How is MSCT performed?

The device is adjusted to the desired structure depending on its density
The patient changes into loose clothing without metal parts (usually a light disposable gown)
All jewelry, watches, and dentures are removed during the procedure.
The subject lies comfortably on a flat tomograph table

Further movements will be performed only by the device:

The table progressively moves into the device as the desired area of the body is scanned, and the sensors rotate around it, illuminating the selected structures
The patient does not experience any sensations during the procedure
When a contrast agent is injected, a slight metallic taste in the mouth and a feeling of spreading warmth may occur, but this quickly passes

Differences between MSCT and MRI

Imaging method: MSCT is x-rays, MRI is magnetic waves that are reflected from tissues
Oncological diagnostics: MSCT is preferable
Indications: MSCT is the method of choice for visualizing bone structures, MRI – soft organs and tissues
Contrast agent: in MSCT – iodine preparation, in MRI – gadolinium-based (less allergenic than iodine-based)
Frequency: MSCT – according to indications, MRI – without restrictions
The presence of metal and electronic implants in the body, tattoos with metal-based paint: MSCT - no contraindications, MRI - contraindicated
Children's age, pregnancy: MSCT is contraindicated, MRI is allowed from the 12th week of pregnancy (children under 7 years old are performed under anesthesia)
Duration of the procedure: MSCT – 5–15 minutes, MRI – up to 30 minutes

Contraindications and risks

The main limitations to CT scanning relate to the use of contrast media.

But there are some risks that the patient should be aware of:

Frequent CT scans at a young age increases the risk of development, worsening or recurrence of cancer
Research may lead to malfunctions of electronic implants

Advantages of carrying out the procedure at MEDSI

Modern MSCT devices allow you to carry out the procedure as quickly as possible and minimize the radiation dose
High accuracy and detail of images allow diagnosing pathology at an early stage, which improves the prognosis of the disease
Tests are carried out by qualified and experienced radiologists
More than 25 types of research

Make an appointment by calling 24/7 8 (495) 7-800-500.

How is the procedure done?

The procedure is as follows:

Before starting, the patient is placed on a special table, which slides inside the tomograph, in which the scanning itself is carried out.
During the examination, the tomograph ring rotates around the table with the patient. At this stage, it is critical that the patient remains completely calm.
At the time of the procedure, the diagnostician is in a closed room, observing the progress of the procedure through transparent glass.

What equipment and are there any restrictions?

The type of CT scanner used is important for the procedure to be successful. The tomograph can be:

Open.
Closed - looks like a sealed tube into which the patient is placed using a retractable table. This type of design allows you to study only the necessary area of the body, which minimizes the impact of a directed flow of ionizing radiation on the entire body.

A closed-type device cannot be used for CT examinations of patients with fear of closed spaces and obesity. To examine such patients, only an open type apparatus is used.

How to prepare for a CT scan, what to take with you?

Basically, computed tomography does not require any preparatory measures. However, in some cases, preparation will still be needed.

Preparation is carried out in the case of CT examination of the gastrointestinal tract. In this case, preparation is carried out according to the following algorithm:

A few days before the procedure, fatty, fried and salty foods are excluded from the diet.
On the day of the procedure, a cleansing enema is performed.
On the day of the procedure, it is prohibited to eat food of any kind.

To undergo a CT scan, you must provide the attending physician with the following documents:

Referral from a specialist providing treatment.
Results of past diagnostic studies.

What will I get after a computer examination, where to go with the results?

After completing the diagnosis, the patient is given the resulting images, as well as their interpretation and a medical report. By prior agreement, the results of the study can be sent to the attending physician or patient by e-mail or recorded on an electronic storage medium.

With the results obtained, you must contact your doctor, who, after reviewing and interpreting the results, will give the necessary recommendations.

If the tomography was carried out without a medical prescription (at personal request), contact a specialized specialist with the results.

Computed tomography in St. Petersburg

If you need to have a CT scan in St. Petersburg and the choice of a medical institution is difficult due to lack of time, on the website mrt-v-spb.ru you can find all the necessary information regarding CT scanning in St. Petersburg (addresses and prices).

The patient can also learn about:

where to get a CT scan in St. Petersburg (in total, information about more than 100 medical institutions is available);
where to get a brain tomography in St. Petersburg;
what equipment is used when performing CT scans in St. Petersburg.

The price for CT scans in St. Petersburg ranges from 700 to 20,000 rubles. You can make an appointment by calling the phone number located on the main page of the site.

CT scan of the chest: what will it show and how will it help the patient?

Computed tomography of the chest (CT CT) is one of the modern diagnostic methods. When and for what purpose may you need to do a CT scan of the chest? What does it include?

These and other questions are answered by Yulia Aleksandrovna Rutskaya, Deputy Chief Physician for Radiation Diagnostics, radiologist of the highest qualification category “Clinic Expert” Kursk.

— Yulia Aleksandrovna, how often do patients come to you for a CT scan of the chest?

“People come to our clinic for this service every day. Computed tomography of the chest organs accounts for on average more than a third of all examinations per day. Now, during the coronavirus epidemic, these numbers are, of course, much higher.

— What does a chest CT scan show?

- Anything that goes into the chest. First of all, the study allows us to study the condition of the lungs. We can assess the location of the vessels and bronchi, their patency, and find out whether there are neoplasms, inflammatory processes, or congenital pathologies in the lungs. Also, with the help of this study, you can see the esophagus, dilatation (expansion) of the chambers of the heart and large vessels, and the condition of the mediastinal lymph nodes.

In addition, we see a frame formed by the ribs, the thoracic spine, and the sternum. These bony structures are assessed for destructive changes.

— What diseases can be identified or excluded during this study?

— The main pathologies that can be detected are pneumonia (pneumonia) of various natures, including viral, tuberculosis, the detection of which is of social importance, and lung cancer. Interstitial lung diseases are also detected, diffusely affecting the lung tissue; accumulation of fluid in the pleural cavity; tumors and metastases in the lungs, bones and mediastinum (for example, thymoma, lymphoma, dermoid tumors, cysts, esophageal tumors); abnormalities of bone structure.

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— Yulia Aleksandrovna, please tell us how a CT scan of the chest organs is done

— First of all, the patient undergoes a registration procedure in our clinic. This takes 5-10 minutes. Then the laboratory assistant accompanies him to the locker room, where the patient undresses to the waist. A mandatory requirement is to remove all metal jewelry. The patient lies on a special tomograph table on his back. The tomograph itself is a ring-shaped device that rotates smoothly around the patient and takes pictures.

At the command of the radiologist, the patient inhales and holds his breath 2-3 times for a certain time (from 10 to 30 seconds). Next comes the processing of information received by the radiologist from the tomograph computer. The doctor previews the images over the next 10-15 minutes. If no changes are detected, the result is reported to the patient immediately, but the specialist needs time to describe the images. The conclusion is sent to the patient via email within a few hours, or he can pick it up from the clinic himself the next day.

Read material on the topic:

Electronic media for recording MRI studies: marketing ploy or benefit to patients?

— What is the purpose and how is a CT scan of the chest organs with contrast performed? What is special about this type of research?

— Such a study is carried out, for example, if there is a suspicion of a blood clot in the pulmonary artery. This condition is life-threatening; contrasting is required to clarify the diagnosis. In addition, we perform CT of the chest with contrast when there are space-occupying formations in the mediastinum or roots of the lungs. Contrasting allows you to study in detail the localization and spread of the tumor, assess its nature, and the location of the vessels in it.

The contrast agent is an iodine-containing substance that is injected using a special syringe-flask at the beginning of the procedure.

— Is preparation required for this study? If so, how to prepare for a chest CT scan?

— No special preparation is required for traditional CT examination of the OGK. If a contrast study is necessary, the patient must first undergo blood tests to assess the kidney's glomerular filtration rate and creatinine level. The doctor also finds out whether the patient has a history of severe allergic reactions, bronchial asthma, or individual iodine intolerance.

— In what cases is CT scanning of the chest organs contraindicated?

— Absolute contraindications are pregnancy and excess weight (more than 150 kg). A contrast study is not performed in cases of severe renal failure or individual iodine intolerance; it is used with caution in cases of diabetes mellitus and thyroid pathologies.

— Is it possible to do a CT scan of the chest organs for children?

— It is possible, at any age, only if there are direct indications and no contraindications. I would like to note that this requires a referral from a specialist with justification for conducting this particular study.

— And if an adult wants to sign up for a CT scan of the chest organs, does he need to take a referral from a doctor?

— It is desirable because from the referral the radiologist receives preliminary information about the expected diagnosis and, based on it, decides how best to conduct the study, and also determines further tactics for managing the patient.

Interviewed by Sevilya Ibraimova

If you need a CT scan of the chest, you can sign up for the study here ATTENTION: the service is not available in all cities

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For reference:

Rutskaya Yulia Alexandrovna

Graduate of the medical faculty of Kursk State Medical University in 2002. In 2004, she completed an internship in radiology. Currently, she is the deputy chief physician for radiation diagnostics, a radiologist of the highest qualification category at the Expert Clinic Kursk. Receives at the address: st. Karl Liebknechta, 7