CT examination of the spine. Computed tomography of the lumbosacral spine. What shows a computed tomography of the spine

A CT scan of the spine is an X-ray image of all parts of the spinal column. The investigated area of \u200b\u200bthe human body is scanned at once from different angles. The information received is processed by a computer and displayed as layer-by-layer images. Since the tomograph can take pictures in different sections, they are very clear, and do not interfere with seeing the soft tissues located behind them. Modern equipment allows scanning very quickly, sometimes in a few seconds.

What does a CT scan of the spine show? This method of examining the human body allows you to examine and examine in detail the vertebrae, their processes, intervertebral discs, ligaments and spinal cord, as well as assess the condition of the soft tissues located near the spinal column (cartilage, tendons, muscles, blood vessels). CT provides clear and detailed pictures of organs, bones, and vascular systems, which distinguishes it from an x-ray examination.

As a rule, CT is prescribed to study diseases, pathologies and injuries in the back. A study can also be prescribed if a person complains of persistent headaches, back pain of unknown origin. Such a study can be prescribed by doctors for the prevention of diseases, especially for people engaged in heavy physical labor with severe back loads, and athletes.

Indications for CT of the spine

MRI better "sees" soft tissues (muscles, brain, nerves, intervertebral discs, blood vessels), but is not suitable for examining dense structures, therefore CT is prescribed for examining bone tissue.

Diseases of the spine, especially osteochondrosis, occur in a huge number of people and occupy a significant share among neurological and musculoskeletal disorders. Previously, only radiography was used for diagnostics, which in recent years has been successfully replaced by tomography. In particular, CT of the spine is a very accurate diagnostic method that allows you to find any disorder of the back health.

The computed tomography machine allows for a detailed, layer-by-layer scan of our main supporting mechanism - the spine. Computed tomographs use the minimum dosage of X-ray radiation, the dose of which does not exceed the standard for radiography, and in the latest generation tomographs it is much lower.

The information content of CT images is very high. The thing is that scanning is carried out in three projections with slices of 1-2 millimeters, so the resulting picture will accurately reflect the state of one or another part of the spinal column. Additionally, CT of the spine will visualize adjacent to the vertebrae:

Internal organs.
Bones.
Soft tissue.
Blood vessels
Nerve trunks and plexuses.

As for the spine itself, after a CT scan, its condition will be clearly visible with detailed information about the vertebrae, intervertebral cartilages, spinous processes, and the spinal canal.

The benefits of spine CT are undeniable:

High scanning speed
Accuracy
Great potential in diagnostics
The ability to perform CT with contrast enhancement

CT of the spine with a hernia

It is the herniated disc that is the main indication for the examination of the spinal column. A CT scan is recommended for everyone who suffers from severe back pain, does not tolerate the load on the back, has lumbago in the leg, arm, and other serious symptoms. A hernia is a complication of an advanced form of spinal osteochondrosis and is able to follow the existing protrusion.

Most often, hernias are found in the lower back, therefore the most popular type of tomography is CT of the lumbosacral spine. In this case, the lower segment of the spine, sacrum and coccyx are scanned. If necessary, an examination of two areas of the spine is performed at once, but no more - due to the use of X-rays.

Indications for spine tomography

Cervical spine CT is often recommended for patients. In the initial segment, the size of the vertebrae is very small, as is the thickness of the discs, so the likelihood of developing protrusions and hernias is also high here. Also, the examination will help to assess the condition of the first two vertebrae and the craniovertebral junction (the junction with the base of the skull), where fractures and other pathologies sometimes occur.

CT scan of the thoracic spine is most often prescribed for different types of deformity and curvature. Osteochondrosis is less common here, but scoliosis and other anomalies and deviations are common. In general, the main indications for spinal tomography by department are:

Deformities of the vertebrae, processes
Spinal stenosis
Intervertebral hernia
Bone tissue abnormalities
Spinal destruction
Trauma
Hematomas
Muscle congestion

The procedure will help you see new growths at the earliest stage, including cancerous and benign tumors, as well as metastases. Usually, to differentiate pathology with benign tumors, CT of the spine with contrast is performed. A contrast agent will also be necessary to identify problems with blood vessels, for example, with the vertebral artery. Tomography is needed for emergency diagnostics - for injuries, injuries, urgent operations, as well as before a planned operation and to monitor its results.

Regular headaches
Fainting
Pain under the scapula, in the ribs
Back pain
Irradiating pain
Numbness of hands, feet
Some types of disorders of the internal organs

Preparation for the procedure

If CT is performed with the introduction of a contrast agent, it is recommended not to eat 6 hours before the examination. Tomography of the cervical, thoracic spine segment without contrast does not require preparation. When a patient is advised to scan the lower spine, the following preparation steps should be taken:

Refusal of food that increases gas formation 2 days before CT
Consumption of rice dishes
If necessary - taking the drug "Espumisan" before the procedure, as well as "No-shpa" (with strong gas formation and active intestinal peristalsis)
In the evening on the eve of CT - setting a cleansing enema
Abstaining from food for 8 hours

You need to come directly to the examination in loose clothing, take off your jewelry, watch, and put your phone in your bag (things usually remain in a special utility room). You should take your previous examinations and an outpatient card with you.

How is CT of the spine done?

The patient lies down on the couch before scanning. If necessary, a contrast agent is injected through a vein. During the entire procedure, he should not move at all. The table is pushed under the cylindrical device of the tomograph, after which the doctor leaves the room. Next, a series of photographs is taken, and they are recorded on tape and decrypted by a computer.

Based on the images, a specialist radiologist makes a decoding of the state of the examined spine and adjacent tissues. The printouts of the images with the description are handed over to the patient, who must hand them over to the doctor who sends them to the CT.

The CT scan takes only 5 minutes when it comes to scanning one section of the spine. Examination of two departments will take twice as long - about 10 minutes. The method is very quick, painless, which only increases its advantages.

The price of the procedure varies depending on the type of clinic, type of tomograph (multi-slice CT is usually more expensive). On average, the cost is 2500-3800 rubles for the diagnosis of the state of one segment of the spine.

Who is CT scan contraindicated for?

CT scan with contrast is prohibited for allergies to iodine, hyperthyroidism, and a number of other somatic diseases. CT as an X-ray examination method is prohibited at any stage of pregnancy. During lactation, the procedure can be done, but breastfeeding should be suspended for at least a day.

CT scan of the back is limited for:

Large body mass
Claustrophobia
Other phobias and mental disorders
Severe back pain
Severe heart disease

Compression fracture of the spine
Spine tumors
Osteochondrosis
Spondylosis
Intervertebral hernia
Protrusion
Scoliosis
Kyphosis
Pathological lordosis
Compression of blood vessels and nerves
Spinal stenosis
Spondyloarthrosis
Bechterew's disease
Spinal tuberculosis
Scheuermann-Mau disease
Spondylitis
Spine osteoporosis

CT scan of the spine is much more effective than X-ray, reflecting the condition of the back and neck, allowing an accurate diagnosis. Its cost is higher, but the results and safety are more incomparable, which should be the determining factor for the patient.

The method by which it is possible to study the human body by "scanning" it in different intersecting planes is computed tomography (CT). Until recently, the survey was carried out using a conventional X-ray. This method of diagnosis was uninformative and had a negative impact on the patient. It was replaced by computed tomography, which allows you to obtain a clear detailed image of all internal organs and tissues of a person.

CT of the spine: the essence of the research method

CT allows specialists to examine any part of the spine using computer processing. Due to X-ray irradiation with the use of modern technologies, it is possible to scan the body in layers from 0.5 to 1 mm thick. This diagnostic method has several advantages:

the ability to check each section of the spine;
the image is as detailed as possible;
control can be carried out during biopsy and puncture;
after the operation, the recovery dynamics of the patient is monitored;
angiography may be done.

With the help of CT of the spine, intervertebral hernias, congenital anomalies of the vertebrae and joints, displaced injuries, cysts, neoplasms, metastases, osteoporosis, osteomyelitis and other pathologies are detected. If a patient is diagnosed with breast or prostate cancer, then patients should be examined on a regular basis, since there is a high risk of metastasis to the spine.

Computed tomograph works according to the following principle:

Diagnostic indications

The indications for CT are very diverse. Sometimes the patient needs to examine the cervical spine, since the small size of the vertebrae in this area does not allow identifying hernias and protrusions when using other diagnostic methods. If there is a suspicion of a fracture of the base of the skull or the detection of pathology of the first two vertebrae, CT is more informative. Often, computed tomography is performed on patients with deformation or curvature of the thoracic spine.

The main indications for CT are:

various spinal injuries;
strong muscle tension;
hernia;
pathological narrowing of blood vessels;
development of destructive changes in the vertebrae;
anomalies in the structure of bone tissue.

Thanks to modern diagnostic methods, it is possible to identify neoplasms at an early stage of their development and metastases. The injected contrast allows you to see clear images of the vertebral artery in case of vascular problems.

Often, the tomograph saves the lives of patients who have suffered a serious injury, received a serious injury, or in the event of an emergency operation. Doctors quickly identify the affected areas, which further helps to avoid serious complications.

CT screening tests are performed when the following symptoms are present:

pain in the lumbar region, under the scapula or in the ribs;
numbness in your arms or legs;
frequent headaches;
violations in the work of internal organs;
pain of a radiating nature;
periodic loss of consciousness.

Contraindications

Although tomography is a relatively safe diagnostic method, it is prohibited for some people. Pregnancy of the patient is a serious contraindication to CT of the spine. It's all about the negative effects of X-rays on the fetus in the womb.

Such an examination cannot be performed on young children, although in some cases computed tomography is still prescribed. You can minimize the risks by resorting to another diagnostic method - MRI.

If a person has neuropsychiatric disorders, then this fact will also be considered a contraindication. Frequent involuntary movements during the procedure can distort the image, the results of CT will be unreliable. Sometimes these patients are scanned under general anesthesia.

The tomograph table is designed for a weight of no more than 150 kilograms, therefore, overweight people will be refused examination. Allergic reaction to contrast, renal failure and pathological changes in the heart are direct contraindications to CT.

Preparing for CT of the spine

The patient needs to prepare for a CT scan. You can improve the image quality of the lower spine by following a special diet. A couple of days before the procedure, you should refuse food that can lead to increased gas production in the digestive tract. Bakery products, dairy products, vegetables, fruits and legumes should be excluded.

Immediately before scanning, you can take drugs to reduce the amount of gases in the intestine (activated carbon, Espumisan, etc.) and antispasmodics (No-shpa), which help reduce peristalsis.

Survey technology

Before the patient is placed on the bed of the tomograph, he should remove all accessories with metal components, otherwise shadows will be visible on the images that make diagnosis difficult. Clothing should be loose, not restricting movement, in which for a long time a person will be comfortable lying down.

The patient is located on the couch lying on his back, hands behind his head. So that during the procedure the patient does not move, he is fixed with belts, sometimes the doctor may ask him to hold his breath so that the pictures are clearer. The contrast agent is injected into a vein before the scan begins.

When the preparation is completed, the couch moves with the person inside the apparatus. During the procedure, medical workers leave the room, going to the next room, where there is a special window for observing the patient.

The tomograph takes pictures, after which they are processed by a computer. Then the doctor analyzes the images, evaluates their quality and clarity, if all requirements are met, the procedure is over.

What do CT scans show?

A radiologist or a specialist in the field of radiation diagnostics is taken to decipher the images obtained, on average it takes from half an hour to an hour. In addition to CT, the doctor takes into account the results of additional examinations, the conclusions of highly qualified specialists of other specialties and an epicrisis about the patient's condition with appropriate therapy.

By what CT shows, the doctor is able to determine the presence of pathological changes in organs and tissues, correlated with the patient's diseases. The conclusion that the radiologist gives is not a diagnosis. Determine the exact cause of the disease is only able to the attending physician, who collected an anamnesis, examined, studied the results of analyzes and tests. The obtained images can be provided to the patient on a digital carrier, in printed form on paper or film.

Spiral computed tomography

The best diagnostic method for examining the soft tissues of the human body today is spiral computed tomography (SCT), its principle of operation is similar to classical computed tomography, but the harmful effects of X-rays are reduced several times. Spiral computed tomography allows you to quickly and thoroughly identify various pathological processes occurring in:

the brain;
liver;
spleen;
pancreas.

Also, SCT images can reveal neoplasms in soft tissues. Using this method, it is possible to determine the damage to internal organs, spinal cord, spine and gastrointestinal tract, resulting from trauma.

If a person is being treated, then SCT will help track the positive dynamics of the patient's condition with the prescribed therapy. So doctors manage to prescribe effective treatment, which will quickly help the patient and avoid relapses in the future.

With the development of technology, multislice or multislice tomography (MSCT) has appeared, thanks to which it is possible to scan much faster, increase the area of \u200b\u200banatomical coverage and contrast resolution.

Examination cost

How much will such a procedure cost? The cost of computed tomography can vary depending on:

volumes of the study area;
the use of a contrast agent (the cost of the examination is higher);
type of apparatus (spiral, multispiral, classic);
provided discounts and current promotions.

If such a procedure is provided in a Moscow clinic, then its cost will be on average $ 100. In Belarus, such a medical service will cost half the price, about $ 50. In Kiev, a spine scan costs $ 40. If a contrast agent is required, the price will be twice as high. Israeli and German clinics offer MSCT at a price of $ 850 to $ 1000.

Spine CT is a computed tomography scan of the vertebra. Such a device differs from radiography by its large range of functions, the presence of a clear three-dimensional image and the ability to scan in transverse and longitudinal projections. This leads to the fact that all internal organs, soft and bone tissues, nerve threads, blood vessels are better displayed in the photo.

During the CT scan of the spine, all its parts are very clearly displayed:

intervertebral discs;
vertebrae;
the canal of the spinal cord (partially visible).

The CT scan procedure has several stages.

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The patient should lie on the table and, if possible, not move.
The table moves along the cylindrical scanner.
When the first batch of shots is taken, the table is pulled back.
Doctors inject the patient with a contrast agent. At this stage, you should carefully monitor the occurrence of an allergic reaction.
The table is again moved along the cylindrical scanner. A series of photographs are taken and recorded on magnetic tape.
After the last examination, it is worthwhile to once again make sure that the patient does not have symptoms of vomiting, dizziness and nausea.

During a CT scan, specialists set the parameters for the movement of the rays. They make small slices from which to compose the image.

From the images, doctors can determine the deformation of the intervertebral discs and vertebrae, poor blood circulation, damage to the spinal canal, various kinds of fractures, the presence of hematomas and muscle congestion.

The printed images are transferred to the patient, and their electronic version is stored in the computer in archival documents. Therefore, you can always restore snapshots if necessary.

When do CT scan

Elements that cannot be traced on radiography should be examined on more powerful devices, such as computed tomography.

In modern times, such a procedure can be carried out for many purposes:

screening;
emergency diagnostics;
routine diagnostics;
full examination before surgery.

Screening tests are done when the patient is asymptomatic. So, CT of the cervical spine is prescribed in some cases:

impassable pain in the head;
the presence of constant fainting conditions;
neck and head injuries without loss of consciousness.

Emergency diagnosis takes place when a patient has a critical health condition, which can occur for several reasons:

spinal fracture;
spinal cord injuries;
the presence of squeezed vessels.

Routine CT scan of the spine is carried out to determine the exact diagnosis of the patient in the case when the disease is accompanied by certain conditions:

intervertebral hernia;
determination of the severity of congenital defects of the spine;
the presence of tumors on the spine;
spondylosis and so on.

Contraindications and precautions

Like other scanners, CT scans of the spine may have contraindications that need to be prevented:

it is forbidden to carry out the procedure to people who have allergies and individual intolerance to iodine and iodine-containing products;
it is forbidden to carry out the procedure for pregnant women at any time;
patients suffering from claustrophobic disease must take sedatives before immersion in the scanner capsule;
CT is not performed when the patient's body weight exceeds the weight of the device;
people who feel pain in the back should relieve pain by drinking analgesic medications.

CT scan of the lumbar spine

After CT of the lumbar spine, you can see the general condition of the bone tissue, partly the structure of the spinal canal. If the situation is slightly worse, then the following is observed:

violation of the ligaments;
damage to the intervertebral discs;
inflammation of a separate part of the spine;
degeneration of tissues and so on.

In such cases, CT is done to confirm the x-ray results.

However, sometimes a more extensive examination of the vertebra is required - CT of the lumbosacral spine. Such cases are associated with:

spinal fracture;
osteochondrosis;
malignant and benign tumors of the vertebrae;
the presence of herniated intervertebral discs;
hemorrhage in the spinal canal;
osteoporosis;
congenital developmental defect of the spine;
mobility of the vertebrae;
spinal stenosis.

Preparing for CT scan of the lumbosacral spine

If the examination is carried out with the introduction of a contrast agent within 6 hours, then you must refrain from eating. In other cases, no special training is required.

The patient should take the following documents with him:

direction for CT scan;
outpatient card or an extract from it;
pictures and their description when passing earlier than other procedures;
other documents related to the disease.

CT scan for children

The safest age for CT scan in children is 12 years and above. CT scans can be performed in special children's medical centers under the age of 12. In frequent cases, children are given anesthesia, since each movement inside the scanner capsule can give an erroneous result.

If you feel back pain, you should diagnose all parts of the vertebra:

CT of the sacroiliac joint;
CT of the cervical spine;
CT scan of the coccyx area;
CT of the thoracic spine.

What can be seen on a CT scan of the cervical spine

CT examination of the cervical spine is carried out in order to fully diagnose and study diseases of the spinal column at the neck level. Such tomography can quite clearly show the general condition of the spinal processes and bodies, spinal canals, and the spinal cord. She shows a little worse ligaments and intervertebral discs.

Thanks to the three-dimensional image, using CT, you can quickly and clearly determine the presence of fractures, hematomas, various kinds of tumors, congenital abnormalities and other changes.

Preparation for the procedure

Before performing computed tomography, various preparatory measures should be taken:

the patient must wear a disposable gown;
it is forbidden to lie on the tomography table for various kinds of jewelry made of metal: brooches, hairpins, rings, chains, etc.
be sure to remove devices and accessories that can spoil the image of the pictures: dentures, glasses, bra;
if the patient suffers from allergies, then you need to warn the doctor about this, since with the introduction of a contrast agent, the allergic reaction may reappear;
during the procedure, the patient must be completely immobilized.

CT cost

Depending on the area of \u200b\u200bthe spine being examined, the cost of computed tomography can vary from 3,500 rubles and more. However, you should not save on your health, it is better to undergo an examination and correctly diagnose the disease.

Compared to X-ray, CT of the spine is the most informative method for examining bones and soft tissues located in the cervical, thoracic, lumbosacral and coccygeal regions. Layered images obtained as a result of scanning are very clear, they can be used to diagnose pathologies and systemic disorders in the intervertebral discs, spinal cord and nerve roots, blood vessels, muscles and tendons. The effect of X-rays on the human body with this method is insignificant.

Indications for appointment

Computed tomography is indicated for frequent symptoms such as numbness in the arms and legs, spasms in the chest area, severe headaches, discomfort in the back and limbs.

Thanks to 3D-images, the doctor can determine the causes of these problems and prescribe adequate therapy.

This procedure is carried out by CT scan diagnosticians using special high-tech devices as prescribed by a surgeon, traumatologist or neuropathologist.

This type of research is used for the following problems:

trauma and compression fractures;
congenital pathologies of the development of the vertebrae;
neoplasms and metastases;
scoliosis, kyphosis;
intervertebral hernias and protrusions;
osteochondrosis;
inflammatory diseases of the back muscles;
back pain of unknown origin.

Computed tomography is also prescribed to clarify information on the diagnosis made from X-rays.

CT is often done before surgery and at different phases of the rehabilitation period. This allows you to assess the effectiveness of the operation, possible complications, the condition of the nerve fibers and the degree of tissue regeneration.

Preparation for the examination

Before prescribing a tomography, the doctor must consult the patient, explain the purpose of this measure, reassure the patient, and determine whether exposure to radiation is harmful for this patient.

In order to avoid nervousness during the procedure, the doctor explains that this study is painless, therefore, during the scan, you need to lie still and still. Otherwise, the quality of pictures may deteriorate.

The doctor should find out if the patient has any allergic reactions to iodine preparations, seaweed, seafood, as well as to a contrast agent. Information about individual intolerance to contrast is indicated in the medical history.

The patient also needs to prepare before the procedure. It is recommended to wear loose-fitting clothing without zippers or metal trim. Before entering the tomography room, you must remove all jewelry, watches, leave your phone.

If the study is carried out with the use of contrasting, experts recommend that you first refrain from heavy food, and come to the procedure on an empty stomach (with a simple CT scan, the diet is not changed). You must first donate blood for biochemical analysis.

During the tomography, adverse reactions to the contrast agent are possible: dry mouth, dizziness, a slight increase in body temperature. These symptoms are considered normal.

If the patient's condition has deteriorated sharply, he must immediately inform the diagnostician using a special sound transmission device.

Before computed tomography, the patient or his relatives give written permission for the study.

How is computed tomography

The design of the tomograph is arranged in such a way that it allows scanning all parts of the spine sequentially and at different angles.

When all the preparatory procedures have been completed, the patient is brought into a specially equipped room and placed on a table. A rubber bulb is given in the hand to communicate with the diagnostician if the patient has problems during the study. The stage automatically slides into the cylinder-shaped chamber of the device.

X-rays are sent through this device, which pass around the investigated area of \u200b\u200bthe human body, with the help of the sensor, the information is transmitted to the computer. The program processes the data obtained from the tomograph and forms them in the form of layer-by-layer images of the spine scanned at a given depth.

The device emits loud sounds during operation. This is normal and will not cause any harm to the person. If they bother the patient, earplugs may be offered.

Computed tomographs work quickly, but it will take about 20-30 minutes to fully study all parts of the spine.

After the completion of the procedure, the patient is removed from the cylindrical arch, the tomography ends.

The next step is to assess what the resulting images show. A CT diagnostician with a medical education is engaged in decoding the results of tomography. Information about the condition of the spine is printed on the official letterhead of the clinic, signed by a specialist and sealed by the institution. Pictures are printed or recorded on electronic media. This information is transmitted to the patient or his attending physician and serves as a material for establishing or clarifying the diagnosis.

What the procedure allows to determine

CT diagnostics reveals the following disorders:

Cracks in the vertebrae, their displacement relative to the column, other consequences of trauma.
Spinal cord injury, hematoma, pinched nerve roots.
Narrowing and widening of the lumen inside the spinal canal.
Schmorl's hernia, the beginning of osteoporosis.
Bone growths in the form of osteophytes, indicating the presence of arthrosis.
Bone and soft tissue tumors.
Reducing the height between the vertebrae due to the destruction of the intervertebral discs.
Other destructive disorders and abnormalities in the development of different parts of the back.

If scanning is carried out after surgery, the photo can be used to study the degree of tissue regeneration and the general postoperative state of the spine.

Contraindications

Although computed tomography is considered a harmless diagnostic method, even the smallest amount of X-ray radiation negatively affects the human body to some extent.

If the patient has recently undergone a radiation examination, it is recommended to appoint a CT scan only after a month.

This type of diagnosis is contraindicated for the following categories of citizens:

pregnant women (radiation can greatly affect the development of the fetus);
people with severe kidney failure, diabetes, thyroid problems;
patients with oncological diseases of the skin;
children under 12 years old.

Nursing mothers need to be careful when examining by CT and replace breast milk with special mixtures for a day, the contrast will have to be abandoned.

This method is not available for people weighing more than 200 kg, since the design of the device has restrictions on weight parameters.

There is a danger for allergy sufferers: people with individual intolerance to contrast media are prohibited from performing tomography with its use. If a person did not know about this, at the first symptoms he is shown antihistamines.

Conclusion

Computed tomography of the spine is a fast and affordable method for examining soft structures and bone tissues. Compared to a simple X-ray, the dose of harmful radiation during CT is minimal, but at the same time, the images obtained are more informative, since they allow you to assess the state of the spinal column in three projections.

The procedure of this type of research is painless, only rest is required from the patient. For the purpose of a detailed study of the state of the nerve fibers, contrast agents are used that penetrate into the patient's corresponding tissues and make them sensitive to the effect of the device; such structures are reflected in the images more clearly, they are easier to visualize and evaluate.

However, before undergoing such an examination, each person needs to familiarize himself with the list of contraindications, and if any, the patient should refuse to order a CT scan and consult with the attending physician about replacing it with a more suitable study.