Powerpoint Flashcards
Routine Ct abdomen(8)
Masses Lesions Vascular abnormalities Trauma Abscesses Gi tract conditions Appendicitis Renal, hepatic, pancreatic, splenic abnormalities
2 types oral contrast for abdomen
Barium sulfate( 1-3%)
Water soluble (1-3%) ( gastrograffin)
Contrast administered (3)
Orally
Rectally
Ostomy
Ng tube
Suspected bowel perforation or surgery potential
Water soluble contrast
Oral contrast prep
Studies in morning: clear liquid supper the night before and npo after midnight
Why? Avoid intragastric masses and ingested food or aspiration if vomiting occurs
Studies performed in the afternoon
Clear liquid supper and breakfast and npo after breakfast
Laxatives may be given ensure digestive tract free of fecal material
Patient consumes____ to ____ of oral contrast ___-____ prior scanning. Then ___-___ ml of oral contrast just before scanning to coat stomach and duodenum
300-500 ml
30min-1 hour
200-300ml
When pelvis is included have patient consume ______-____ ml oral contrast _____-___ hours prior to scanning and ___-___ ml of oral contrast prior scanning
900 - 1200 ml
1-1 1/2 hrs
200-300 ml
Npo patients makes them easier to drink
Patient positioning abdomen ct
Supine
Feet first
Jewelry and clothing containing metal removed . Gown provided
Arms raised
Cushion under patients knee
Immobilization straps
Patient centered midcoronal and midsagital
Shield
On expiration
Abdominal ct protocol
Prep oral contrast
Scout 0 azimuth(ap) from xiphoid to iliac crest approx 300-350 mm . If including pelvis thru pubic symphysis 500-600 mm total
Optional: lateral scout to center coronally
5mm slices from 1 cm above the diaphragm to iliac crest or to pubic symphysis for pelvis
No gantry angulation
Inject 50-120cc contrast at rate of 60-90 seconds delay at 2-3 sec( venous phase)
Ped dose; 1cc/ per lb
Full expiration
Acquire scan 5min delay thru bladder
Lung bases in lung window ww 1500 wl -500
Mediastinal windows ww 350 wl 50
Liver from superior to inferior liver window ww 100 wl 200
Trauma bone window ww 2500 wl 500
Contrast and stones
No contrast with stones same ct #
Ct abdominal aorta for aneurysm or dissection
Oral contrast not necessary
Perform with and without
Noncontrast for calcified aorta
Scout azmiuth( ap) xiphoid to iliac crest approx 300-350mm . Pelvis included extend thru pubic symphysis 500-600 mm
Lateral scout center coronally
2-5 mm slices from 1cm above the diaphragm to iliac crest for pelvis pubic symphysis
No gantry angulation
Helical acquisition
Inject 80-120 cc of Iv contrast material with 20-35 sec delay at 3-5 cc sec arterial phase
Full expiration
Mediastinal window ww 350 wl 50 on both contrast and no contrast
On contrast series, lung window ww1500 wl -500
Liver from superior to inferior with liver window ww 100 wl 200
Trauma for bone ww2500 wl 1500
MIPS reconstructed as thin as possible for aorta 3d
Measure both true lumen and aneurysms at largest diameter
Triphasic renal protocol
Prep with oral contrast
Scout 0 azmiuth (ap) from xiphoid to iliac crest 300-350mm. For pelvis thru pubic symphysis
Lateral scout center coronally
Start with noncontrast series through abdomen or just through kidneys 2-5 mm
No gantry angulation
Helical acquisition
Inject 80-120 cc of Iv contrast material with 60-90sec delay at 2-3cc sec
Ped dose 1cc/lb
Full expiration
Acquire additional scans thru kidneys after 5 min post injection delay
Mediastinal window ww 350 wl 50 on both contrast and no contrast
On contrast series, lung window ww1500 wl -500
Liver from superior to inferior with liver window ww 100 wl 200
Trauma for bone ww2500 wl 1500
MIPS reconstructed as thin as possible for aorta 3d
Place a hounsfield measurement on the renal abnormality in each phase
Triphasic renal protocol done for?
Renal masses or cysts
Three phase liver or pancreas done for ?
Three phase liver or pancreas done for hepatic or pancreatic lesions also done pre and post liver transplant to evaluate circulation
