CT chest (summary)

This is a basic article for medical students and other non-radiologists

Chest CT is a computed tomography examination of the thoracic cavity performed for a variety of reasons, from suspected cancer to penetrating chest trauma.

A CT chest can be performed with or without IV contrast and when IV contrast is given, the timing of the contrast delivery can make a massive difference to the ability of the study to answer a specific question. This makes asking a specific question very important, as well as providing appropriate clinical information.

A standard CT chest will be performed with IV contrast and triggered after approximately 20 seconds when the contrast is within the arterial system.

Reference article

This is a summary article; read more in our article on CT chest.

Summary

• indications (acute)
  • suspected lung cancer
  • complex chest infection, e.g. suspected abscess or empyema
  • complex pleural disease
  • vascular disease
  • chest trauma (blunt or penetrating)
• benefits
  • quick and relatively accessible
  • excellent anatomic detail
  • fantastic localization of disease
• limitations
  • radiation dose
  • size and location of cannula will limit vascular assessment
• procedure
  • patient positioned supine in CT scanner
  • contrast injected into a peripheral cannula
  • CT clavicles to costophrenic angles
    • scan when contrast density in aortic reaches a specific value
• variations
  • CTPA
    • CT pulmonary angiogram
    • contrast examination of the pulmonary arterial system
  • CTA chest
    • CT angiogram
    • a.k.a. CT aortogram
    • contrast examination of the arterial system
    • requires rapid injection of contrast
  • HRCT chest
    • high-resolution CT chest
    • non-contrast examination
    • assessment of lung parenchyma
    • may be performed as selected slices or as a volume
• similar tests
  • chest x-ray
    • first line test for chest pathology