Upper Back (Thoracic Spine) CT Scan (with contrast)

What it is

A CT scanner rotates an x-ray tube around the body and reconstructs the readings into cross-sections, which can then be stacked and viewed from any direction. Applied to the thoracic spine, it resolves the vertebral bodies, the bony arches behind them, and the canal they enclose in far more detail than plain film. Adding intravenous contrast changes what the scan is good for. Iodine circulates in the blood, so tissue with abnormal or increased blood flow — the rim of an abscess, a tumor, inflamed tissue around a disc — lights up against its surroundings. This code is the contrast-enhanced study of that region; scans done without contrast, and studies done both ways, are coded separately.

Why it is done

• To investigate a suspected infection of a vertebra or the disc space, or a collection of pus pressing on the spinal canal
• To look for a tumor in or around the bone, including a cancer that has spread to the spine, and to define its extent
• To follow a known mass or infection through treatment
• To clarify a finding from an earlier scan or x-ray that needs contrast to be characterized
• To assess the spine when MRI is not possible, such as when a patient has a device that rules it out

What to expect

Patients are usually asked to fast for a few hours and may have kidney function checked before contrast. An IV goes into the arm. The patient lies on their back on a table that slides through the scanner ring, which is open at both ends rather than a tunnel. Staying still is the main requirement; the scan itself is measured in seconds to a couple of minutes. The contrast injection produces a spreading warmth and a feeling, briefly, of having wet oneself — expected and not real. Images go to a radiologist, and a report generally follows within a day or so unless the study is urgent.

Questions worth asking

• Was the order written for with contrast, without, or both? Each is a different code and price, and the order is sometimes changed at the scanner.
• If more than one region of the spine is scanned in the same session, is each region a separate charge?
• Is the contrast injection itself, and the IV supplies, part of the scan price or an added line?
• Would an MRI answer the same question, and how do the two compare in price at this facility?