Professional Documents
Culture Documents
Chest CT
Protocols
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Educational Objectives
By the end of this lecture you should be able to:
Explain patient preparation for chest CT examinations Explain the CT protocol for :
Routine chest
High resolution Chest State the common indications for each protocol Identify the contrast volume and route of administration for each protocol Identify the standard windowing for each protocol Explain how to modify the technique according to patient condition
References
1. 2. 3. Protocols for Multislice Helical Computed Tomography, The fundamentals. by Peter Dawson Body CT protocols state of the Art , Rogalla P., Mutze S., Hamm B. Text book of radiographic positioning and related anatomy; by Kenneth L.Bontrager,6th edition.
Websites
http://www.ctisus.org/ http://www.halls.md/ct/ct.htm http://www.slaney.org/pct/
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Evaluation of mediastinal or pleural mass Detection of pulmonary metastasis Emphysema (COPD) Patient with Hemoptysis Abscesses or cysts Lung fibrosis Atelectasis Bronchitis (COPD) Guidance FNA
COPD
Chronic Obstructive Pulmonary Disease
Asthma
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Contrast:
The use of contrast media which injected intravenously is important for visualization of structures within the mediastinum. Department protocols/radiologist preferences determine the specific type, volume and site of injection. ( Average dose 100ml) For children 2 ml per kilogram body weight.
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lungs:
WW 1000 to 1500HU WL -600 to -700HU
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Normal Anatomy
1. Coracoid. 2. Right clavicle. 3. Right common carotid artery. 4. Thyroid. 5. Internal jugular vein. 6. Left clavicle. 7. Left Subclavian vein. 8. Left humeral head. 9. Scapular spine. 10. Spinous process.
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Normal Anatomy
1. 2. 3. 4. 5. 6. Right humeral head. Esophagus. Trachea. Left Subclavian vein. Scapular spine. Glena
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Normal Anatomy
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Right lung. Rib. Esophagus. Trachea. Left brachiocephalic vein . Left common carotid artery. Left Axillary vein. Left Lung. Transverse process. Scapula.
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Normal Anatomy
1. 2. 3. 4. 5. 6. 7. 8. 9. Axial cut. Mediastinal Window Right lung. Rib. Trachea. Left brachiocephalic vein . Brachiocephalic artery. Left common carotid artery. Left Subclavian artery. Scapula. Esophagus. Spinous process.
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Normal Anatomy
1. 2. 3. 4. 5. 6. 7. 8.
Right lung. Trachea. Superior vena cava. Aortic arch. Left Lung. Scapula Vertebral body. Rib.
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Normal Anatomy
1. 2. 3. 4. 5. 6. 7. 8. 9. Right lung. Right pulmonary artery. Superior vena cava. Thoracic ascending aorta. Pulmonary artery root. Left pulmonary vein. Left pulmonary artery. Rib. Thoracic descending aorta
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Normal Anatomy
1. 2. 3. 4. 5.
Right atrium. Aortic root. Right ventricle. Left atrium. Thoracic descending aorta.
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Normal Anatomy
1. 2. 3. 4. 5. 6.
Right lung. Right atrium. Right ventricle. Left ventricle. Left Lung. Thoracic descending aorta.
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Normal Anatomy
1. 2. 3. 4. 5. 6. 7. 8. Right lung. Inferior vena cava. Right ventricle. Left ventricle. Esophagus. Left Lung. Thoracic descending aorta. Spinal canal.
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Normal Anatomy
1. 2. 3. 4. 5. 6. 7. 8. 9. Right lung. Liver. Inferior vena cava. Right ventricle. Left ventricle. Esophagus. Left Lung. Thoracic descending aorta. Vertebral body.
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Normal Anatomy
1, Inferior lobe of right lung. 2, Liver. 3, Inferior vena cava. 4, Esophagus. 5, Left Lung 6, Aorta.
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Normal Anatomy
1. 2. 3. 4. 5.
Inferior lobe of right lung. Liver. Inferior vena cava. Inferior lobe of left lung. Aorta.
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Normal Anatomy
Axial cut. Lung Window
1. 2. 3. 4.
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Apical segment bronchus upper lobe (Right lung). Division of Trachea. Superior lobe of the left lung. Inferior lobe of left lung. Red arrow, Major fissure.
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Normal Anatomy
Axial cut. Lung Window
1. 2. 3. 4. 5. 6.
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Posterior segmental bronchus upper lobe (right lung). Anterior segmental bronchus upper lobe (right lung). Right main bronchus. Left main bronchus. Superior lobe of the left lung. Inferior lobe of left lung. Red arrow, Major fissure.
Normal Anatomy
Axial cut. Lung Window
1. 2. 3. 4. 5. 6.
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Right lower lobe bronchus. Inferior lobe of the right lung. Right middle-lobe bronchus. Right middle lobe. 5, Superior lobe of the right lung. Superior lobe of the left lung. Inferior lobe of left lung.
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Normal Anatomy
Coronal Reconstruction Image 1. 2. 3. 4. Trachea. Left main bronchus. Right main bronchus. Apical segmental bronchus upper lobe (Right lung). 5. Right lower lobe bronchus. Red arrow, Major fissure.
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Protocols
Reminder
Variables Plain or contrast enhanced Slice positioning Slice thickness Slice orientation Slice spacing and overlap Timing of imaging and contrast administration Reconstruction algorithm Radiation dosimetry
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CHEST ( HRCT)
Thin section and high spatial algorithm makes structures sharper
Indications lung diseases e.g. : Bronchiectasis Pulmonary Fibrosis Emphysema Supine arms elevated above head From lung apices to below diaphragm Breath hold in inspiration ( single breath hold) N/A Pitch : 1 Suggested collimation 64x0,6 mm Slice thickness : 2-3 mm Lung widow Expiration sequence if required
Patient Position Topogram Breathing Contrast Technical Parameters Filming Parameters Comments
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HRCT
Routine CT
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THANK YOU
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