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CT 2 > Abdomen + Pelvis Procedures > Flashcards

Abdomen + Pelvis Procedures Flashcards

1
Q

positioning

A

supine, arm above head

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2
Q

head first or feet first?

A

feet first but will be cephalocaudal

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3
Q

purpose of positive oral contrast

A

to differentiate a fluid-filled loop of bowel from a mass or abnormal collection of fluid

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4
Q

what are examples of positive oral contrast used

A
  • barium sulfate
  • water-soluble contrast
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5
Q

example of low attenuation oral contrast

A

water

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6
Q

what are the advantages of using low attenuation contrast > positive contrast?

A
  • won’t obscure mucosal surfaces
  • won’t obscure abdominal vessels
  • better spatial reso on reconstructed images
  • doesn’t mask radiopaque stones
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7
Q

why is rectal contrast used?

A
  • staging colon ca
  • penetrating trauma, fistulas, anastomotic leaks
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8
Q

example of rectal contrast

A

CO2

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9
Q

purposes of IV contrast

A
  • opacify vessels
  • increase CT density of vascular organs
  • improve image contrast between lesions and normal anatomy
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10
Q

when are multi-phase scans usually performed?

A

imaging liver, pancreas, kidneys

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11
Q

algorithms
WW 450 WL 50

A

standard soft tissue

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12
Q

algorithms
WW 150 WL 70

A

liver

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13
Q

algorithms
WW 1500 WL -700

A

lungs

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14
Q

algorithms
WW 2000 WL 600

A

bone

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15
Q

typically, DFOV is set to…

A

just include skin surface

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16
Q

indications for CECT Routine Abdomen + Pelvis (RAP)

A
  • abdominal mass
  • tumour staging
  • abscess
  • non-specific abdominal symptoms
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17
Q

type of contrast used for RAP

A

IV contrast or oral

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18
Q

what flow do you set the IV contrast for RAP

A

125 ml at 3.0 ml/sec, 50 ml NaCl flush

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19
Q

scan delay for RAP

A

65 secs - portal venous phase

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20
Q

volume of oral contrast used for RAP

A

675 ml barium sulfate (1.5 bottles) over 2 hours
(final 225 ml just prior to scanning)

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21
Q

anatomy region for venous chest

A

above lung apices to below costophrenic angles

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22
Q

anatomy region for venous abdomen only

A

above diaphragm to 1cm below iliac crest

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23
Q

anatomy region for venous abdomen and pelvis

A

above diaphragm to pubic symphysis

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24
Q

mA for CECT CAP

A

avg 230

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25
Q

reconstruction slice thickness/increment for CAP

A

5mm/5mm

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26
Q

indications for CECT chest, abdomen, pelvis (CAP)

A
  • infection
  • mass
  • trauma
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27
Q

what are the two scans done for CAP

A
  1. venous chest
  2. venous ab/pelvis
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28
Q

IV contrast rate for CAP

A

125 ml at 3.0ml/sec, 50 ml NaCl flush

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29
Q

scan delay for CAP - Chest

A

35 secs - late arterial/venous phase

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30
Q

scan delay for CAP - ab/pel

A

65 secs - portal venous phase

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31
Q

volume of oral contrast for CAP

A

900 ml 1 hour prior

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32
Q

what does appendicitis look like on a ct scan?

A
  • dilated, non-opacified appendix
  • fat stranding
  • appendicolith
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33
Q

4 indications on a ct scan to rule out appendicitis

A
  1. appendiceal lumen contains air or contrast
  2. <6mm in diameter
  3. appendiceal wall <2mm thick
  4. no “stranding”
34
Q

anatomy included for appendicitis scan

A

above diaphragm to below pubic symphysis

35
Q

is contrast used for appendicitis scans?

A

yes - IV and oral

36
Q

algorithm used for appendicitis scans

A

standard soft tissue

37
Q

mA for appendicitis scan

A

avg 230, atcm (btw 100-575)

38
Q

reconstruction of appendicitis scan
slice thickness/interval

A

2.5mm/1.25mm

39
Q

algorithm(s) used for CAP

A

soft tissue and lung

40
Q

rate of IV contrast for appendicitis scans

A

125 ml at 3ml/sec, 50 ml NaCl flush

41
Q

scan delay for appendicitis

A

65 secs

42
Q

HU for normal liver

A

38-70 HU

43
Q

indications for liver imaging

A
  • fatty infiltration
  • cavernous hemangioma
  • hypervascular tumor
  • liver mets
44
Q

how do you most accurately assess the liver?

A

NECT abdomen

45
Q

how do you diagnose livers?

A

comparison of HU of liver to spleen

46
Q

hepatic arterial phase

A

17-25 secs

47
Q

late hepatic arterial phase

A

40-55 secs

48
Q

portal venous phase

A

65-80 secs

49
Q

hepatic venous phase

A

75-85 secs

50
Q

early delayed hepatic phase

A

3-5 mins

51
Q

vascular equilibrium phase

A

3-5 mins

52
Q

late delayed hepatic phase

A

10-15 mins

53
Q

parenchymal equilibrium phase

A

10-15 mins

54
Q

how does cavernous hemangioma look on NECT

A

well-defined and hypodense of same density as other fluid-filled spaces

55
Q

how does cavernous hemangioma look on CECT

A

progressive pooling of contrast at lesion’s peripheral (centripetal filling)

56
Q

enhancement for hypervascular tumors

A

late arterial phase (35-45 secs)

57
Q

liver mets are (hyper/hypo)vascular

A

hypovascular

58
Q

enhancement for liver mets

A

portal venous phase (60-80 secs)

59
Q

anatomy for CECT arterial venous liver

A

just above diaphragm to iliac crests

60
Q

algorithms used for CECT arterial venous liver

A

soft tissue and liver

61
Q

reconstruction slice thickness/interval for CECT arterial venous liver

A

2.5mm/2.5mm

62
Q

rate for IV contrast for CECT arterial venous liver

A

125 ml at 4 ml/sec, 50 ml NaCl flush

63
Q

IV contrast scan delay for arterial (CECT arterial venous liver)

A

35 secs

64
Q

IV contrast scan delay for venous (CECT arterial venous liver)

A

65 secs

65
Q

oral contrast used for CECT arterial venous liver scans = 900 ml water, how much do we give 30 mins prior? 10 mins prior? just prior?

A

30 mins - 450 ml
10 mins - 225 ml
just - 225 ml

66
Q

what scans use water as oral contrast?

A

pancreas and arterial venous liver scans

67
Q

indication for NECT pancreas

A

calculi in pancreatic or common bile duct

68
Q

indication for CECT pancreas

A

pancreatitis, mass/tumors

69
Q

what can be done if scans can’t differentiate pancreas from duodenum

A

scan RLAT decubitus position

70
Q

difference between arterial venous pancreas scan delay for arterial vs. arterial venous liver scan delay for arterial

A

pancreas - scan delay art = 40 secs
liver - scan delay art = 35 secs

71
Q

why CT for urinary tract calculi?

A
  • high diagnostic accuracy
  • most types of stones are visible
  • can undergo 3d reconstruction
  • give info on degree of obstruction
72
Q

slice thickness needed to identify stones for calculi scans

A

<2.5mm

73
Q

indications for NECT ab/pel for calculi

A
  • urinary tract calculi
  • renal colic
  • flank pain
74
Q

KUB

A

NECT ab/pel for calculi

75
Q

anatomy region for nect ab/pel calculi

A

2cm above kidneys to symphysis pubis

76
Q

mA for nect ab/pel calculi

A

100 mA if pt <165lb otherwise, 0.7*pt weight (lbs)

77
Q

indications for CT colongraphy

A
  • positive FIT test
  • contraindication/failed/incomplete colonoscopy
78
Q

contraindications for CT colonography

A
  • bowel obstruction
  • toxic megacolon
  • acute abdomen or acute diverticulitis
79
Q

what prep is required for ct colonography

A

clear liquid diet with laxatives, oral contrast and suppositories

80
Q

double contrast is required for CT colonography. which two?

A
  1. rectal contrast - co2
  2. oral contrast - barium and water-soluble agent
81
Q

anatomy region for ct colonography

A

just above diaphragm to lesser trochanters

82
Q

mA for ct colonography

A

120

CT 2 (7 decks)

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