CT chest (summary)

Last revised by David Luong on 13 Jun 2021
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

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