Professional Documents
Culture Documents
Body CT Protocols
Body CT Protocols
Chest CT Protocols
ABDOMEN/PELVIS I+
CHEST I
RENAL-3 phases
ENTEROGRAPHY
RENAL STONE
CHEST I+
CT CYSTOGRAM
LIVER-2 phases
LIVER-3 phases
CTA Cardiac
PANCREAS-2 phases
ADRENAL-3 phases
CHEST/ABDOMEN/PELVIS I+
Appendix
RENAL-3 phases.
Oral Prep:
None
Scanning:
Injection rate: 4cc/sec
1.
Ithrough kidneys only
2.
I+
nephrographic phase~90 seconds after injection starts, through kidneys
only
3.
Delay excretory phase, delay of ~5 minutes through kidneys only
Post processing/reformatting/sending:
Send to PACS:
1.25mm axial recons-all phases
5mm axial recons-all phases
3mm coronal and sag recons-all phases
Unenhanced:
a. Low dose, above kidney to below bladder
2. Nephrogram phase :
a. abdomen pelvis (most sensitive for detection of urothelial tumors and bladder
masses)
b. 110ccs at 4cc/sec, scan abdomen pelvis at 100 sec
3. Excretory phase: abdomen pelvis
a. 10mg IV Lasix 3-5min prior to excretory phase
Post processing/reformatting/sending:
Send to PACS: reconstruct at 1.25mm @0.625 intervals
1.25mm axial recons-all phases
5mm axial recons-all phases
3mm coronal and sag recons-all phases
3D reformats (for delays only)
3D rotation of kidneys, ureters and bladder
3D rotation of kidneys, ureters and bladder with transparent bone
Unenhanced:
a. Low dose, above kidney to below bladder
Post processing/reformatting/sending:
Send to PACS: reconstruct at 1.25mm @0.625 intervals
1.25mm axial recons-all phases
5mm axial recons-all phases
3mm coronal and sag recons-all phases
3D reformats (post contrast image set)
3D rotation of kidneys, ureters and bladder
3D rotation of kidneys, ureters and bladder with transparent bone
LIVER-2 phases.
Oral Prep:
None
Scanning:
Injection rate: 4-5cc/sec
1.
I+
Late arterial phase-25 sec after start injection
2.
I+
PV phase-60-70 sec after start injection
Post processing/reformatting/sending:
Send to PACS: (for each phase)
1.25mm axial recons
5mm axial recons
3mm coronaland sag recons
LIVER-3 phases.
Oral Prep:
None
Scanning:
Injection rate: 4-5cc/sec
1.
I+
Late arterial phase liver only - 25 sec after start injection
2.
I+
PV phase entire abdomen - 60-70 sec after start injection
3.
I+
Delay- liver only ~5 minutes after start injection
Post processing/reformatting/sending:
Send to PACS: (for each phase)
1.25mm axial recons
5mm axial recons
3mm coronal and sag recons
None
Scanning:
Injection rate: 4-5cc/sec
1.
ILiver only
2.
I+
Late arterial phase liver only - 25 sec after start injection
3.
I+
PV phase entire abdomen - 60-70 sec after start injection
Post processing/reformatting/sending:
Send to PACS: (for each phase)
1.25mm axial recons
5mm axial recons
PANCREAS-2 phases.
Scanning:
Injection rate: 4-5cc/sec
1.
I+
Pancreatic phase ~35 sec after injection starts, through pancreas only
*as thin as possible*
2.
I+
PV phase-60-70 sec after start injection. Entire abdomen
Post processing/reformatting/sending:
Send to PACS: (for each phase)
1.25mm axial recons
2.5mm axial recons
3mm coronal and sag recons
3D reformats available on request:
Curved reformats of pancreatic duct on late arterial phase
ADRENAL-3 phases.
CHEST/ABDOMEN/PELVIS I+
Oral Prep:
Select
Scanning:
I+
PV phase~60-70 seconds after injection starts
Post processing/reformatting/sending:
Send to PACS:
1.25mm axial recons in standard algorithm
5mm axial recons in standard and lung algorithm
3mm coronal recons
ABDOMEN/PELVIS I+
Oral prep: Select from list
Scanning:
I+
PV phase~60-70 seconds after injection starts
Post processing/reformatting/sending:
Send to PACS:
1.25mm axial recons
5mm axial recons
3mm coronal and sag recons
RENAL STONE
Oral Prep: None
Scanning:
IKidneys through bladder
Post processing/reformatting/sending:
Send to PACS:
1.25mm axial recons
5mm axial recons
3mm coronal and sag recons
CT CYSTOGRAM
Trauma or Post op (Based on Vaccaro and Brody, RadioGraphics 2000; 20:1373
1381 and Chan et all, AJR 2006; 187:12961302) (Based on Tonolini and Bianco, Insights
Imaging. 2012 Apr; 3(2): 181187)
Post processing/reformatting/sending:
Send to PACS: reconstruct at 1.25mm @0.625 intervals
1.25mm axial recons-all phases
5mm axial recons-all phases
3mm coronal and sag recons-all phases
3. Lower leg
3D reconstructions
- 3D rotation of aorta through anterior and posterior tibial arteries ( 3 separate
stations)
-
3D rotation of aorta through anterior and posterior tibial arteries with transparent
bone ( 3 separate stations)
2.
Delay
Post processing/reformatting/sending:
Send to PACS:
1.25mm axial recons-all phases
5mm axial recons-all phases
3mm coronal and sag recons-all phases
3D Reformats:
- 2mm MIP coronal oblique through renal artery origins
- 3D rotation of aorta and kidneys (arterial images)
- 3D rotation of aorta and kidneys with transparent bone
- 3D rotation of kidneys, ureters and bladder (delay images)
- 3D rotation of kidneys, ureters and bladder with transparent bone (delay)
- Thick section MIP of collecting systems
CHEST CT PROTOCOLS
CHEST I- Done for grading aortic calcifications, evaluating esoph leak
*Scan at end inspiration after hyperventilation
Post processing/reformatting/sending:
Send to PACS:
3.75 mm axial in standard algorithm
3.75 mm axial recons in lung algorithm
1.25 mm axial recons in standard algorithm
3mm coronal recons in standard algorithm
CHEST I- Limited/low dose done for eval or follow up pulmonary nodule, r/o
bronchiectasis, r/o emphysema, r/o pneumonia
*Scan at end inspiration after hyperventilation
Low dose ~75-100mA
Z-axis coverage may be limited per discretion of protocoling radiologist
*write this in the comments/special instructions*
Post processing/reformatting/sending:
Send to PACS:
3.75 mm axial in standard algorithm
3.75 mm axial recons in lung algorithm
1.25 mm axial recons in standard algorithm
3mm coronal recons in standard algorithm
CHEST I+
Scanning:
*Scan at end inspiration after hyperventilation
I+
~25 seconds after injection starts (smart prep in descending aorta)
Post processing/reformatting/sending:
Send to PACS:
3.75 mm axial in standard algorithm
3.75 mm axial recons in lung algorithm
1.25 mm axial recons in standard algorithm
3mm coronal recons in standard algorithm
CTA Cardiac
Scanning:
Injection rate: 5cc/sec
1.
I2.5mm (25cm FOV) ECG gating axial mode standard algorithm, full chest
2.
Timing run
3.
I+
0.625mm ECG gating helical mode default 75% phase standard, through
heart (*Extend Z-axis coverage for post CABG to full chest)
Post processing/reformatting/sending:
Send source images to GE ADW
Send to PACS:
IAxial recon full FOV lung algorithm
I+
Axial recon 0.625mm 40-70% @5% increments standard
I+
Axial recon 1.25mm 0-90% @10% increments standard
3D reconstructions
Calcium scoring
Angiographic views
Ejection fraction (if requested)
Full function (if requested)
APPENDIX
CHEST CT PROTOCOL MODIFICATIONS
The following protocol modifications may be written in the "Comments/Special Instructions" box of the prot
Please write out complete instructions, not just a "title".
1. PLEURAL EFFUSION WORK-UP
4. SOLITARY PULMONARY
NODULE
Residents/fellows/attending: Drs. Black and Czum are available and happy to discuss
these and any other potential Chest CT modifications with you.