RadteraCT Thoracic Spine (Routine)
CTNo contrastSpine
Indications
- Thoracic back pain with suspected degenerative or osseous abnormality when MRI contraindicated
- Evaluation of compression fracture, osseous lesion, or kyphosis
- Post-operative hardware/fusion assessment
- Localization of level/lesion characterization
Patient prep
- No prep or contrast for routine study
- Arms raised above head to reduce shoulder artifact when tolerated
- Supine, immobilize; localize level relative to a counted reference (sacrum or C2)
Contrast
None / non-contrast
Technique
- Supine; helical volume covering C7/T1 through L1 (include cervicothoracic and thoracolumbar junctions for counting)
- 120 kV; mAs per scanner with AEC; iterative reconstruction
- Reconstruct thin (0.625-1.25 mm) bone and soft-tissue kernels
- Reformat sagittal and coronal in bone and soft-tissue algorithms
- Quiet breathing; arms up to reduce beam hardening
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial bone | axial | 0.625-1.25 mm | Vertebral bodies, facets, costovertebral joints |
| 2 | Axial soft tissue | axial | 1.25-3 mm | Disc, paraspinal, canal |
| 3 | Sagittal reformat (bone & soft tissue) | sagittal | 1-2 mm | Alignment, height loss, canal |
| 4 | Coronal reformat (bone) | coronal | 1-2 mm | Scoliosis, level counting |
Key points
- Always provide a reliable counting method (extend coverage or correlate with prior imaging) — thoracic level miscounts are common
- MRI preferred for cord/marrow; CT best for cortical detail, fracture morphology, and fusion assessment
- Report alignment, fractures (acute vs chronic), degenerative change, and any aggressive osseous lesion
- Arms-up positioning reduces shoulder beam hardening over upper thoracic levels
References
• ACR–ASNR–ASSR–SPR Practice Parameter for the Performance of CT of the Spine
• ACR Appropriateness Criteria: Thoracic Back Pain
• Radiopaedia: CT thoracic spine (protocol) link
• RadioGraphics: Imaging of Vertebral Fractures
• ACR Appropriateness Criteria: Thoracic Back Pain
• Radiopaedia: CT thoracic spine (protocol) link
• RadioGraphics: Imaging of Vertebral Fractures
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.