A computed tomography (CT) scan uses
X-rays to make detailed pictures of structures inside
of the body.
During the test, you will lie on a table that is
attached to the CT scanner, which is a large doughnut-shaped machine. The CT
scanner sends X-rays through the body area being studied. Each rotation of the
scanner takes less than a second and provides a picture of a thin slice of the
organ or area. All of the pictures are saved as a
group on a computer. They also can be printed.
An iodine dye
(contrast material) is often used to make structures
and organs easier to see on the CT pictures. The dye may be used to check blood
flow, find tumors, and look for other problems. The dye can be used in
different ways. It may be put in a vein (IV) in your
arm, or it may be placed into other parts of your body (such as the
rectum or a joint) to see those areas better. For some
types of CT scans you drink the dye. CT pictures may be taken before and after
the dye is used.
A CT scan can be used to study all parts of your
body, such as the chest, belly, pelvis, or an arm or leg. It can take pictures
of body organs, such as the liver,
pancreas,
intestines,
kidneys,
bladder,
adrenal glands, lungs, and heart. It also can study
blood vessels, bones, and the spinal cord.
Fluoroscopy CT
is a special test that is not widely available. It uses a steady beam of X-rays
to look at movement within the body. It allows the doctor to see your organs
move or to guide a
biopsy needle or other instrument into the right place
inside your body.
CT scans are used to study areas of
the body and the arms or legs.
Chest (thorax). A CT scan of the chest can look for
problems with the lungs, heart,
esophagus, the major blood vessel (aorta), or the tissues in the center of the chest.
Some common chest problems a CT scan may find include infection,
lung cancer, a
pulmonary embolism, and an
aneurysm. It also can be used to see if cancer has
spread into the chest from another area of the body.
Urinary tract. A CT scan of the kidneys,
ureters, and bladder is called a CT KUB or CT urogram.
This type of scan can find
kidney stones, bladder stones, or blockage of the
urinary tract. See a picture of a
CT of diseased kidneys. A special type of CT scan, called a CT intravenous
pyelogram (IVP), uses injected dye (contrast material) to look for kidney stones, blockage, growths, infection, or
other diseases of the urinary tract.
Liver. A CT scan can find liver tumors, bleeding
from the liver, and liver diseases. A CT scan of the liver can help determine
the cause of
jaundice.
Pancreas. A CT scan can find a tumor in the
pancreas or inflammation of the pancreas (pancreatitis).
Gallbladder and bile ducts. A CT scan can be used
to check for blockage of the
bile ducts.
Gallstones occasionally show up on a CT scan. But
other tests, such as
ultrasound, usually are used to find problems with the
gallbladder and bile ducts.
Adrenal glands. A CT scan can find tumors or
enlarged adrenal glands.
Spleen. A CT scan can be used to check for an
injury to the
spleen or the size of the spleen.
Arm or leg. A CT scan can look for problems of the
arms or legs, including the shoulder, elbow, wrist, hand, hip, knee, ankle, or
foot.
Other uses for a CT scan
A
CT scan may be used to make sure a procedure is done correctly. For example,
the doctor may use CT to guide a needle during a tissue biopsy or to guide the
proper placement of a needle to drain an
abscess.
For people with cancer, a CT
scan can help determine how much the cancer has spread. This is called staging
the cancer.
Have had an X-ray test using barium
contrast material (such as a
barium enema) or have taken a medicine that contains
bismuth (such as Pepto-Bismol) in the past 4 days. Barium and bismuth show up
on X-ray films and make it hard to see the picture clearly.
Become
very nervous in small spaces. You need to lie still inside the CT scanner, so
you may need a medicine (sedative) to help you relax.
Arrange for someone to take you home in case you get a
medicine to help you relax (sedative) for the test.
If you have a
CT scan of your belly, you may be asked to not eat any solid foods starting the
night before your scan. For a CT scan of the belly, you may drink contrast
material. For some CT scans, you may need a laxative or an
enema before the test.
Talk to your
doctor about any concerns you have regarding the need for the test, its risks,
how it will be done, or what the results will mean. To help you understand the
importance of this test, fill out the
medical test information form(What is a PDF document?).
You
may need to take off any jewelry. You will need to take off all or most of your
clothes, depending on which area is studied. You may be able to wear your
underwear for some scans. You will be given a gown to use during the
test.
During the test, you will lie on a table that is attached to
the CT scanner, which is a large doughnut-shaped machine.
The
table slides into the round opening of the scanner, and the scanner moves
around your body. The table will move while the scanner takes pictures. You may
hear a click or buzz as the table and scanner move. It is very important to lie
still during the test.
During the test, you may be alone in the
scanning room. But the technologist will watch you through a window. You
will be able to talk to the technologist through a two-way intercom.
If dye (contrast material) is needed, it will be given in one
of several ways, depending on the body area being studied.
Contrast material may be given in a vein (IV) in the arm for
chest, belly, and pelvic CT scans.
You may drink contrast material
for a belly CT, or it may be put through a tube into your bladder or
rectum, or it may be put through a thin needle into a
joint.
A CT scan usually takes 15 to 30
minutes.
Drink lots of liquids for 24 hours after the scan to help
flush the dye out of your body.
You will not have pain during the test.
The table you lie on may feel hard and the room may be cool. It may be hard to
lie still during the test.
Some people feel nervous inside the CT
scanner.
If a medicine to help you relax (sedative) or
dye (contrast material) is used, an IV is usually put in
your hand or arm. You may feel a quick sting or pinch when the IV is started.
The dye may make you feel warm and flushed and give you a metallic taste in
your mouth. Some people feel sick to their stomachs or get a headache. Tell the
technologist or your doctor how you are feeling.
The chance of a CT scan causing a problem is
small.
There is a chance of an
allergic reaction to the dye (contrast material).
If you have diabetes or take metformin
(Glucophage), the dye may cause problems. Your doctor will tell you when to
stop taking metformin and when to start taking it again after the test so you
will not have problems.
There is a slight chance of developing
cancer from having some types of CT
scans.1 The chance is
higher in children, young adults, and people who have many
radiation tests. If you are concerned about this risk, talk to your doctor
about the amount of radiation this test may give you or your child and confirm
that the test is needed.
There is a slight risk that the CT scan can interfere
with implanted or external medical devices. Examples of medical devices include
pacemakers, insulin pumps, defibrillators, and
neurostimulators.
The following may stop you from
having the test or may change the test results:
Pregnancy. CT scans are not usually done during
pregnancy.
Barium and bismuth used for another test. These
substances show up on a CT scan. If a CT scan of the belly is needed, it should
be done before any tests that use barium, such as a
barium enema.
You are not able to lie
still during the test.
Metal objects in the body. These items, such
as surgical clips or metal in joint replacements, may prevent a clear view of
the body area.
Sometimes your CT test results may be different
than those from other types of X-ray tests,
magnetic resonance imaging (MRI), or
ultrasound scans because the CT scan provides a
different view.
Children who need a CT scan may need special
instructions for the test. The child will likely need to hold his or her breath
during the scan. If the child is too young to hold still or is afraid, the
doctor may give the child a medicine (sedative) to
help him or her relax.
If your child is scheduled for a CT scan,
talk with your child's doctor about the need for the scan and the risk of
radiation exposure to your child.
Special
CT scanners called spiral (helical) CT scanners and multi-slice (or
multi-detector) CT scanners are sometimes used for this test. Many modern
scanners are multi-slice scanners. These scanners can be used for many
conditions, such as finding
kidney stones, a
pulmonary embolism, an enlarged
prostate gland, or
atherosclerosis. These special CT scanners can:
Take better pictures of blood vessels and
organs so other imaging tests may not be needed.
Complete scans and
provide pictures in less time.
CT results are often compared to positron
emission tomography (PET) results to help find cancer. Some new scanners do
both scans at the same time.
An electron beam CT scan is another
type of CT scan that can find atherosclerosis and
coronary artery disease. An electron beam CT scan is
much faster than a standard CT scan and can take a good picture of a coronary
artery while the heart is beating. Electron beam CT scans are not widely
available. Another type of CT scanner, the multi-slice CT scan, is nearly as
fast as electron beam CT scanners and is more widely available.
Cardiac calcium artery scoring can help find out risk for heart disease. This test is not done very often, because a physical exam and other tests often give enough information about your heart. This test is not advised for routine screening.
MRI may give different information than a CT scan about certain
conditions.
For more information, see the
medical test
Magnetic Resonance Imaging (MRI).
Experts
disagree about the use of a CT method called full-body scanning to screen for
coronary artery disease and cancers. Full-body scanning is expensive, can lead
to unnecessary tests or surgery, and may increase the chance of cancer from the
radiation exposure. Most doctors do not recommend these studies unless a person
has a specific risk for a certain disease.
Einstein AJ, et al. (2007). Estimating risk of cancer
associated with radiation exposure from 64-slice computed tomography coronary
angiography. JAMA, 298(3): 317–323.
Other Works Consulted
Bleumke DA, et al. (2008). Noninvasive coronary artery
imaging: Magnetic resonance angiography and multidetector computed tomography
angiography. A scientific statement From the American Heart Association
Committee on Cardiovascular Imaging and Intervention of the Council on
Cardiovascular Radiology and Intervention, and the Councils on Clinical
Cardiology and Cardiovascular Disease in the Young. Circulation, 118(5): 586–606. Originally published online June
27, 2008 (doi: 10.1161/circulationaha.108.189695).
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
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