Chest CT Imaging

Saturday, December 3, 2016

Chest or Thoracic Structures CT Scan


CT imaging of the chest presents unique challenges because of the continues motion of the heart and vascular structures. Improvement in temporal and spatial resolution that have been realized as a result of multidetector row CT (MDCT) have been particularly valuable in thoracic imaging. This technology allows the entire thorax to be scanned with thin sections during a single breath hold technique, making consistent high resolution imaging possible. Electrocardiographic (ECG synchronization with MDCT is another valuable tool used to reduce cardiovascular motion artifact and improve image quality. Postprocessing techniques, such as the 3 dimensional 3D and multiplanar reformation MPR can accurately display the pulmonary and coronary vasculature. These new, noninvasive CT imaging techniques can augment, and sometimes replace, the information provided from more invasive test such as aortography, pulmonary angiography and coronary angiography. Despite the enormous benefits presented by newer technologies, not all technical and diagnostica problems have been solved. We continue to struggle to find an ideal compromise between image quality, diagnostic accuracy and patient radiation dose.

General Chest CT scanning Methods


Most Chest protocols are performed while the patient lies in a supine position on the scanning table with the arms elevated above the patient head. In a few instances, primary high resolution CT protocols of the lungs, additional scan are done with the patient in the prone position. Using the shortest scan time possible helps to reduce artifacts created by respiration of patient. Whenever possible, scan of the thoracic should be acquires within a single breath-hold, as this will prevent misregistration that may be caused by uneven patient breathing between scans.

Pulmonary Vessels and Ribs CT Scan


The chest or thorax has the highest intrinsic natural contrast of any body part. The pulmonary vessels and the ribs have significant different attenuation values compared with the adjacent aerated lung. In most adults, the mediastinal vessel and lymph nodes are surrounded by enough fat to be easily identified. Because of the intrinsic natural contrast, IV iodinated contrast medium administration is not necessary for all thoracic indications. Like, scans done for the screening, detection, or exclusion of pulmonary nodule of primary lung diseases such as emphysema or fibrosis are typically done without IV contrast administration. The use of Intravenous contrast medium is typically requested by the radiologist to differentiate vascular from nonvascular structures, particularly lymph nodes, to evaluate cardiovascular structures by seeing in the inside of these structures and to further characterize lesions by observing their pattern of enhancement.

Esophagus and Gastroesophageal CT Scanning


The demarcation of the esophagus and the gastroesophageal junction can be improved by giving the patient an oral contrast agent, most often a barium suspension, shortly before beginning the scan, but is not necessary for most thoracic CT examinations.

Chest CT Anatomy


A routine chest protocol includes both soft tissue and lung windows to evaluate mediatinal structures in conjunction with the tissue. Scans extend from the lung apices to under the diaphragm including the adrenals when there is no history of certain sarcomas. The administration of intravenous contrast material is dependent on the clinical indication and the preference of the radiologist. Demarcation of the esophagus can be improved by giving an oral barium suspension shortly before starting the scan.

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