CT Procedure protocols Flashcards
head
-without: intracranial hemorrhage, early infarction, dementia, hydrocephalus, cerebral trauma
-with and without: mass, lesion, arteriovenous malformation, metastasis, aneurysm, headache and seizure
-scout: AP and lateral
-start: just above skull base
-end:just above vertex
-IV contrast if ordered: 100 mL at 1.0mL/s
-scan delay=5 minutes
-DFOV: apron 23cm
-bone algorithm
-WW 4000/400Wl
-slice thickness: 2.5
* tuck patients chin to reduce radiation to lens of eye
temporal bone
-without: cholesteatoma, inflammatory disease, fractures, evaluate implants
-with contrast:IAC tumour, hearing loss, acoustic neuroma, schwannoma
-scout: AP and lateral
-start:just below mastoid process
-end:just above petrous ridges( include all mastoid, internal and external auditory Canal)
-IV contrast: 100mL at 1.0mL/s
-scan delay: once all contrast is administered
-DFOV: apron 9.6cm
-algorithm: bone
-WW:3200
-WL:400
-algorithm: standard
-WW 90
-WL: 35
-DFOV 18
-reformations: coronal and sagittal
-slice thickness: 0.625
sinus
-recurrent or chronic sinusitis
-scout: AP and lateral
-start:above fontal sinus
-end:below ghard palate
-IV contrast: non
-DFOV:16-18 cm
-SFOV: head
-algorithm: bone
-WW:4000
-WL:1000
-algorithm: standard
-WW: 350
-WL: 50
-reformations: axial, coronal, sagittal
-slice thickness: 2.5mm
* position head so hard palate I perpendicular to the table
trauma facial bones
-indication:facial bone fracture or soft tissue injury
-scout: AP and Lateral
-start: just below mandible
-end: just above frontal sinus
-IV contrast: none
-DFOV:18 cm
-SFOV: head
-algorithm: standard
-WW:350
-WL:50
-algorithm: bone
-WW:4000
-WL:400
-reformation: coronal
-slice thickness 1.2
* tuck patients chin toward chest as far as possible
brain perfusion
-indication: acute stroke, vasospasm, to determine cerebrovascular reserve, in conjunction with temporary balloon occlusion
3 scans: non contrast head
contrast head
2nd contrast head with Diamox(if ordered)
-slice location: center at level of basal ganglia
-IV: 50mL(370 concentration) at 4.0ml/s, saline flush at 4.0mL/s
-scan delay: 5 seconds
-DFOV:25
-SFOV: head
-algorithm: standard
-WW:90
-WL:35
-slice thickness: 5.0mm
CTA- circle of Willis
-indications: locate cerebral aneurysm or AVM in patients with SAH/ICH
-non con head then a arterial phase head
-start:at level of C1
-end: just above skull vertex
-arterial phase scan
-IV: 60mL at 4.0mL/s, 20 mL saline at 4.0mL/s
-scan delay: use carotid artery at C4 for ROI
-DFOV:20 cm
-SFOV:head
-algorithm: standard
-WW;140
-WL: 40
-reformations: Axial, coronal, sagittal
-slice thickness: 2.0mm
-WW:800
-WL:200
CTA-circle of willis/carotid
-indications:acute stroke carotid atherostenosis, carotid dissections
-non con head then arterial phase head
-Start: just below aortic arch
-end: just above frontal sinus
-arterial phase
-Iv contrast: 80mL at 4.0 mL
-saline at 4.0mL/s
-scan delay: from timing bolus(use carotid artery at C4 for ROI)
-DFOV: 25cm
-SFOV:body
-through foramen magnum: WW:250, WL:30
-through base of skull: WW:140, WL:40
-through vertex: WW:90, WL:35
CTV-cranial venography
-indications: evaluation of cerebral venous disorders, dural sinus thrombosis
-scout: AP, Lateral
-start:just below skull base
-end: just above vertex
-IV: 100mL at 4.0mL/s
-scan delay for 16 detector: 30 seconds
-scan delay for 64 detector: 45 seconds
-DFOV:25 c,
-SFOV: head
-algorithm: standard
-WW:350
-WL:40
-slice thickness: 2.5mm
-reformations: coronal and sagittal
Neck(soft tissue)
-indications: neck mass, vascular abnormality
-scout: AP and lateral
-Start: mid orbit
-end: clavicular heads
-IV: 125mL at 2.0mL/s split bolus
-1st injection: 50mL
-2nd injection 2 minutes after 1st 75mL
-scan starts 25 seconds after start od second injection
-DFOV:20-24
-SFOV:large body
-algorithm: standard
-WW: 450
-WL: 75
-algorithm: bone
-WW:4000
-WL: 400
C spine
-indications: fracture, dislocation
-scout: AP, lateral
-start: just above skull base
-end: mid T1
-IV: when requested by radiologist: 100mL at 1.5mL/s
-scan delay: when injection is complete
-DFOV:aprox 14
-SFOV: large body
-algorithm: bone
-WW:2000
-WL:500
-algorithm: standard
-WW:350
-WL: 50
-reformations: coronal and sagittal
T spine
-indications: fracture, dislocation
-scouts: AP, lateral
-Start: just above T1
-end: just below T12, include all T spine
-IV: when requested by radiologist: 100mL at 1.5mL/s, scan delay when injection is complete
-DFOV: approx 16
-SFOV:large body
-algorithm: bone
-WW:2000
-WL:500
-algorithm: standard
-WW:350
-WL: 50
-reformations: coronal and sagittal
L spine
-indications: fracture, dislocation
-scout: AP and lateral
-start: just above L1
-end:mid sacrum
-IV: when requested by radiologist: 100mL at 1.5mL, scan delay when injection is complete
-DFOV:14-16
-SFOV:large body
-algorithm: bone
-WW:2000
-WL:500
-algorithm: standard
-WW:350
-WL:50
-reformationsL coronal and sagittal
-slice thickness: 2.0mm
CTA spine
-indications: localization of shunt of spinal dural arteriovenous fistulas, spinal arteriovenous malformation, blunt trauma
-scout: AP and lateral
-arterial phase then delayed scan
-start: skull base
-end: sacrum
-IV: 120mL at 6mL/s
-scan delay: bolus tracking place ROI in the aorta just below diaphragm, manually trigger when enhancement reaches 125HU
-DFOV:20
-SFOV:large body
-Algorithm: standard
-WW:700
-WL:100
-delayed scan
-algorithm: standard
-reformations: coronal, sagittal
-WW:700
-WL:100
routine chest
-indications: infection, mass, empyema of abnormalities discovered on chest xray, evaluation of known or suspected congenital thoracic anomalies, evaluation of trauma
-scout: AP and lateral
-start: just above lung apices
-end: just below costophrenic angles
-breath hold: inspiration
-IV: 80mL at 3.0mL/s with a 50mL spine flush
-oral: for suspected lung cancer give 16 oz barium sulphate jest before exam
-scan delay: 35seconds
-DFOV: approx 38cm
-SFOV:large body
-algoritm: standard
-soft tissue:WW;505,WL;50
-lung:WW:1500, WL;-700
HR chest
interstitial l ung disease
-indications: asbestos exposure, inhalation injury, interstitial disease, diffuse pulmonary disease, suspected bronchiectasis, suspected small airway disease, sarcoid, scleroderma
-3 scans: supine insertion, supine expiration, prone inspiration
-scout: AP and lateral
-start: just above lung apices
-end: just below costophrenic angles
-breath hold: inspiration
-IV: None
-DFOV: approx 38 cm
-SFOV: large body
-algorithm: bone
-WW:1500
-WL:-700(lung)
-scan 3: prone inspiration
-start: carina
-end: just below costophrenic angles
-everything else is same as other two scans
HR chest
OLD(obstructive Lung Disease)
-indications: COPD,lung volume reduction surgery, asthma
-supine inspiration, supine expiration
-start: just above lung apices
-end: just below costophrenic angles
-IV contrast: none
-breath hold: inspiration then expiration
-DFOV: 38sm
-SFOV:large body
-inspiration algorithm: bone
-WW:1500
-WL:-700
-expiration algorithm: standard
-WW:1,500
-WL:-700
chest abdomen
-indications: infection, mass, evaluation of trauma
-venous scan of chest
-start: just above lung apices
-end: just below costophrenic angle s
-IV:125mL at 3.0mL/s
-scan delay: 35 seconds
-oral: 900L 1 hour before scan
-breath hold: inspiration
-DFOV:38
-SFOV:large body
-algorithm: standard
-soft tissue: WW:350, WL:50
lung: WW:1500, WL:-700
-venous scan of abdomen
-65 seconds after start of injection
-start: just above diaphragm
-end: 1 cm below iliac crest
-breath hold: inspiration
-algorithm: standard
CTA- chest for PE
-indications: suspected pulmonary embolism
-scout: AP and lateral(apices to below tibial plateau)
-1: arterial scan:
-start: just below lowest hemidiaphragm
-end: lung apices
-IV: 120mL total. Split bolus;70mL at 4.0mL/s, 25 second pause then reset 50mL at 3mL/s
-scan delay: smart prep; set monitor location at the level of main pulmonary artery, initiate scan at first sight of contrast in main pulmonary artery
-25 second pause after first 70mL injection is complete then 50mL at 3mL/s
-breath hold: stop breathing, avoid deep inspiration
-DFOV:38
-algorithm: standard
-WW:700
-WL: 180
-scan 2: lower extremity runoff-begin 180 seconds off start of contrast
-start: 2 cm below tibial plateau
-end: iliac crest
-breath hold: none
-DFOV:48
-algorithm: standard
cardiac calcium scoring
-indications: assessment of risk in asymptomatic individuals who have one or more risk factors for CAD; evaluation of patients presenting with equivocal symptoms of CAD;follow up of patients undergoing therapy
-Scout: Ap, lateral
-Start: 1 cm below carina
-end: just below apex of heart
-breath hold: inspiration
-IV: none
-DFOV:25
-SFOV:large body
-algorithm: standard
-WW:500
-WL:50
-slice thickness 2.5mm
-algorithm: standard
-include entire chest
routine abdomen pelvis
-indications: suspected abdominal mass, tumour staging, abscess
-scout: AP and lateral
-Start:just above diaphragm
-end:just below symphysis pubis
-breath hold: inspiration
-IV: 125mL at 3.0mL/s, 50mL saline flush
-scan delay: 65 seconds
-oral: 675mL barium sulfate suspension
-DFOV:38
-SFOV:large body
-algorithm: standard
-soft tissue: WW:500, WL:50
-liver: WW:150, WL:70
-lung:WW:1500, WL:-700
-slice thickness:2.5mm
-algorithm: standard
-WW:500
-WL:50
-slice thickness: 5mm
arterial venous liver
-indications:evaluation of suspected hyervascular hepatic tutors, including hepatocellular carcinoma and metastases from carcinoid, islet cell carcinoma, thyroid carcinoma, renal cell carcinoma, breast carcinoma, melanoma and sarcomas
-three phase for suspected hemangioma with second scan repeated 600 seconds after injection
-scout: AP and lateral
-start: just above diaphragm
-end: at iliac crest
-DFOV:38
-SFOV:large body
-breath hold: inspiration
-IV:125mL at 4mL/s, 50mL saline at 4mL/s
-oral: voLumen or water: 450mL 30 minutes before scan, 255mL 10 minutes before, 255mL rigid before scan
-first scan: delay 35 seconds
-algorithm:standard
-soft tissue WW:500, WL:50
-liver WW:150, WL:70
-second scan: delay 65 seconds
-algorithm: standard
-soft tissue: WW:500, WL:50
-third scan(if needed) delay 600 seconds
Arterial Venous Pancreas
-indications:pancreatitis, suspected tutors of the pancreas
-scout: AP and lateral
-start:just above diaphragm
-end: iliac crest
-breath hold: inspiration
-2 scans
-IV: 125mL at 4mL/s, 50mL saline at 4mL/s
-oral: VoLumen 2or water: 450mL 30 min before, 255mL before, 225mL in scan room
-DFOV:38
-SFOV:large body
-first scan-arterial scan
-scan delay: 40 seconds
-algorithm:standard
-soft tissue WW:500, WL:50
-second scan: venous scan
-scan delay:65 seconds
-no additional IV contrast
-algorithm: standard
-soft tissue WW:500, WL:50
-slice thickness 2.5mm
enterography
-indication: crohns, inflamed bowel
-scout:AP and lateral
-start:just above diaphragm
-end: just below symphysis pubis
-breath hold: inspiration
-IV: 125mL at 4mL/s, 50mL saline at 4mL/s
-oral: VoLumen or water:450mL 60 min before, 450mL 30 minutes before, 225mL 20 minutes before, 225mL in scan room
-scan delay: 65 seconds
-DFOV:38
-SFOV:large body
-algorithm: standard
-soft tissue: WW:350,WL:50
-reconstruction 2
-algorithm: standard
-slice thickness 2.5
Appendicitis/diverticulitis
-indications: suspected appendicitis or diverticulitis
-scout: AP and lateral
-start: just above diaphragm
-end: just below symphysis pubis
-IV: 125 mL at 3 mL/s, 50mL saline at 3mL/s
-oral:675mL barium sulfate suspension, 225mL just before scan
-scan delay: 65 seconds
-DFOV:38
-SFOV:large body
-algorithm: standard
-soft tissue WW:500, WL 50
-reconstruction 2
-3 cm above iliac crest through pelvis
-algorithm: standard
-slice thickness: 2.5
