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Computed tomography of the cervical spine is often prescribed by doctors of various specialties, as it is the most effective and economical diagnosis of various problems in this area.
Most often, neurologists, surgeons and therapists send to the office of computed tomography, which is also called simply CT for short. People who are not related to medicine often believe that it only shows the condition of the cervical vertebrae, the problems of which can be seen when examining a conventional x-ray. Yes, and the price will be much lower.
But, in fact, this study allows you to get information about the soft tissues surrounding the vertebrae, as well as about the vascular system of this part of the spine.
Reasons for appointment
Since conventional X-ray images can only detect bone pathology, and ultrasound does not give a general picture of the health of blood vessels, it is easier to do a CT scan once. It provides information about the state of soft tissues, cervical vertebrae and lymph nodes at the same time.
Scanning is carried out using X-rays that penetrate into the area under examination in different projections, and the data obtained is transmitted to a computer, where the result is a clear high-resolution image, which shows all the anatomical features of the cervical region, pathological processes and anomalies of work.
A few years ago, classical spiral tomography was the most popular diagnostic option of this kind. But today they use its improved version – multispiral, which visualizes information much clearer, and also takes less time to complete the study and has reduced radiation exposure.
Usually, such a format of research is not complete with neck and head injuries. But often those people who are suspected of having neoplasms of various etiologies are sent for testing. Not always they can be oncological tumors of a malignant nature.
But if a patient is diagnosed with cancer, then the CT results make it possible to additionally identify metastases, as well as to assess the direction of their spread, to check how badly neighboring organs and tissues are damaged in order to draw up a correct course of therapy in the future.
Detection of the neoplasm is also important for subsequent histology, as a kind of navigator for the surgeon. In addition, high-precision images are a significant help in their work directly during surgical intervention in case of such a need as an emergency scenario. This applies to situations when a foreign body was found in a patient in the region of the cervical spine.
It does not do without a detailed image of the selected zone to draw up a picture of:
- blood flow in the cervical region, which gives an idea of sufficient nutrition of the brain outside the cranium;
- the dynamics of treatment for previously diagnosed purulent or inflammatory processes such as abscess, phlegmon and infiltrates;
- the presence of cysts in the soft tissues of the larynx or neck in general.
Periodically, those patients who have already been there and received treatment based on the data provided are sent for tomography. Now they need control shots to monitor the dynamics of recovery after the detected changes of a different nature. In some cases, the initially prescribed therapy, for example, for the treatment of lymph nodes, may not be effective, as the results of the second analysis will let you know.
Sometimes CT scans are offered even for those who suffer from osteochondrosis of the spine, which has atypical features. The category of fairly rare reasons for issuing a referral also included:
- herniated disc;
- sprain of the cervical ligaments;
- congenital or acquired anomalies of the lymph nodes.
Atherosclerosis and aneurysms can also prompt a doctor to send a ward to undergo a similar study.
Relative spectrum contraindications
Due to the fact that X-ray radiation is used during the examination, doctors prohibit CT scans for women at any stage of pregnancy, since despite the reduced dosage of radiation, the risk of negative effects on the fetus still remains.
The same applies to situations where a woman is breastfeeding a baby. But here the risks are still less, since in order to reduce the danger to the child’s body, the mother is enough to stop breastfeeding him for at least a couple of days after the manipulation. This rule applies to patients who, in addition to scanning, were contrasted.
The remaining contraindications are considered relative. Doctors so call options when the benefits of the examination results significantly outweigh the possible harm. The group of relative prohibitions includes the following items:
- age of 14 years;
- weight over 120 kg, which is caused by the peculiarities of the medical equipment itself;
- allergy to the components of the contrast agent, which is easy to detect with the help of a preliminary allergic test;
- kidney failure;
- severe degree of chronic heart failure;
- Thyroid gland diseases;
- severe degree of development of the stage of diabetes mellitus with various complications.
Situations when the patient is unconscious or has mental health problems are considered separately. It is difficult for them to control their movements, and it is extremely important for the detectors to keep the body motionless throughout the entire time of manipulation.
Implementation mechanism
The most important benefit of diagnosis for patients is painlessness. But at the same time, they will have to come to terms with the fact that the entire period of being under the arch of the scanner must be in a horizontal stationary position.
To make it more comfortable for a person to endure temporary inconveniences, a pillow cushion is placed under his head. The head is fixed with auxiliary straps so that it does not accidentally twitch due to a sudden beep, which the equipment normally emits periodically.
Unlike MRI, where the patient has to stay in an enclosed space for much longer, CT, with its speed, is great for all those who suffer from claustrophobia. If an unforeseen situation occurs during the session, the patient can contact the X-ray laboratory assistant via two-way communication, while continuing to remain motionless.
The patient does not have to perform any special measures before the study. The doctor simply recommends to refrain from eating 6-8 hours before the appointed time. Immediately before laying down on the medical table, the patient is asked to put aside all jewelry and metal objects such as dentures. Given the possibility of the presence of metal parts found in the patient’s clothes, it is better to change into cotton pajamas with ties, or a disposable gown.
When is contrast needed?
If a standard spiral scan is enough to obtain information, then the picture, together with the encrypted conclusion, can be given directly to the patient. This will take approximately half an hour.
The results of the examination include not only pictures, but also a description of the state of the organs, on the basis of which the attending physician will be able to determine the further tactics of managing the patient, if necessary, refer him to a doctor of a different, narrower specialization. This may be a gastroenterologist due to the detection of changes in the upper esophagus. But most often, people who have undergone an examination of the cervical spine are referred to an endocrinologist for the treatment of thyroid diseases or to an ENT. The latter helps to cope with pathologies not only of the pharynx, but also of the larynx.
Sometimes the examined are immediately registered in the oncology dispensary. Moreover, it does not matter at all: whether relatively safe benign tumors or malignant neoplasms were found in them.
With suspicions of an early stage of the development of the disease and in some other cases, doctors prefer to prescribe a referral not just for a spiral scan of the cervical region, but additionally for a study with contrast, which involves the administration of a special drug intravenously.
The solution for CT is made on the basis of iodine, so it is important to find out in advance if a person has any contraindications for its use. The components are excreted naturally with the help of the kidneys with urine. But until the body processes them to the end, the patient may experience a number of normal side effects such as nausea, headache, or fever.
Immediately after the injection of the drug, it will be quickly distributed through the vessels, which in the pictures allows you to more accurately recognize the source of the problem. An auxiliary study will be especially relevant if you want to find minor deviations in order to catch the disease at the phase of its inception and prevent complications.
The doctor makes a verdict on the diagnosis after studying the information received from the radiologist, based on the results of other tests and the history of the victim.