Take a Look at Yourself

Get a picture of health

Have that Fantastic Voyage urge to see the inner workings of your body? Televised surgery doesn't cut it? Then there's the computed-tomography scan. You probably don't need a scan unless you smoked like a chimney, ate like a pig, or drank like a fish--or have a family history of heart disease. But before you write a check at some shady outfit in a strip mall, ask them these questions:


1. What type of scanner do you own? The ideal answer: multislice CT (also known as multidetector CT). While the older electron-beam CT is still great for visualizing the heart, one recent study found that multislice CTs are better for everything else. "EBCT is fine for the coronaries alone, but to do the whole body, you really need a multislice CT," says Eliot Fishman, M.D., head of radiology at Johns Hopkins Medical Institute in Baltimore.


2. Do you use contrast? The best technique--used in university-hospital radiology departments--employs IV contrast, in which a dye is injected or ingested to highlight the difference between normal and abnormal tissues, making problems easier to spot. "If you don't give IV contrast, you can miss a small renal cancer," notes Dr. Fishman. Finding a commercial center that offers the option will take a few phone calls, since many don't offer it because it adds a level of complication and cost.


3. Who reads the scan? As with most medical tests, a CT scan is only as accurate as the person reading it. A lot of centers use retired radiologists or ship your scan to the lowest bidder for evaluation. One chain uses physician's assistants. Insist that a board-certified radiologist read your scan. (You can verify a doctor's certification at www.abms.org.) Or, even better, ask for a radiologist who has postgraduate training, such as a fellowship in CT scanning.



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