Professional Documents
Culture Documents
Scan
Cervical dan Thoracal
ANATOMI
CT Cervical
What Is a Cervical Spine CT Scan?
A cervical spine CT (computed tomography) scan
is a medical procedure that combines specialized
X-ray equipment with computer imaging to
create a visual model of your cervical spine.
Your doctor may order this test if you have been
in a recent accident or are suffering from neck
pain. The exam can help more accurately
diagnose potential injuries to that area of your
spinal column.
INDIKASI
Evaluation of herniated disk or
trauma
Evaluation of degenative disk
disesase
Detection of neoplasm or infection
Evaluation of spinal infection
Evaluation of spinal stenosis
Keterbatasan CT adalah:
1. sulit untuk mengidentifikasi patah
tulang berorientasi pada bidang
aksial (misalnya patah tulang dens).
2. tidak dapat menampilkan cedera
ligamen.
3. biaya yang relatif tinggi.
Patient positioning
Axial
lateral topogram/
scout
(to include entire
neck)
Axial
AP and lateral
topogram/
scout
(to include vertebrae
under
investigation)
NECK IMAGING
- carcinoma
pathologie - abscess
s
- fracture
- retrosternal thyroid
extension
- difficulty in
indications
swallowing
- hoarse voice
- lymphadenopathy
- trauma
AXIAL NECK
start of range 1
end of range 1
Technic
Standard neck imaging consists of a spiral
range that extends from the base of the
skull/hard palate until the thoracic inlet. If
the pathology investigation revolves
around the thyroid, you must check
whether IV contrast is needed.
IV contrast flow rate and volume is 75-100
ml at 2 ml per second.
Continued
Thinly collimated scans made be needed if
the tumour under investigation involves
the vocal cords. These fine slices help
determine exactly where the tumour lies
and what anatomy it encompasses.
Contrast monitoring software is useful in
evaluating the neck. Scan acquisition can
be triggered when there is carotid artery
opacification.
WW:250-500, WC:30-60
Scanogram -trauma
TRAUMA CERVICAL
SPINE
pathologies
indications
- trauma
- paresthesia
- sciatica
- back/neck pain
start of range 1
end of range 1
TECHNIC
Cervical spine trauma protocol is used to evaluate
the stability of a patient's neck in a post trauma
situation. Thinly collimated scans are used to
minimise the risk of missing small fractures.
In the acute stage of investigation the entire
cervical spine should be imaged from the base of
the skull to the end of the first thoracic vertebrae.
If only specific areas are imaged, post-traumatic
fractures can and will be missed.
Speed of examination is important if the patient is
severely ill or uncooperative.
CONTINUED
After the examination is completed
sagittal MPR images must be
produced.
These sagittal images are important
in demonstrating compression
fractures of the vertebrae.
These are very useful, especially in
very large patients where axial scans
can be of poor quality.
Scan Parameters
visualisation imaging
criteria
image reproduction
criteria
anatomy covered
- axial no gantry tilt for trauma studies - axially through the vertebrae and
disks for disk study examination
Scan parameter-trauma
Acquisitio
n
range 1
Axial
Spiral
pitch =
1.5
Slice
Thi
ckn
ess
2 mm
Table
Mov
eme
nt
3 mm
mAs
~100-150
kV
algorith
m
Rotatio
n
Tim
e
IV
cont
rast
140
bone +
soft
tissu
e
adul
t
head
0.75-1.5
seco
nd
CERVICAL DISC
Cervical disc scans are performed infrequently
these days as the majority of cervical pathology is
investigated by MRI. These scans are usually
performed because of patient MRI
contraindications or unavailability.
Sequence scans are obtained through the body of
each cervical vertebrae.
The discs that are scanned are usually from the
base of the skull to the C3-C4 intervertebral disc.
It is very important that the patient does not
move. If the patient moves it usually means that
the topogram has to be repeated and scanning
recommenced.
A stack acquisition from the top of C4 is adequate
in demonstrating the rest of the cervical
vertebrae in a disc series examination.
CERVICAL SPINE
CERVICAL SPINE
DISC SERIES
CERVICAL SPINE
DISC SERIES
CERVICAL SPINE
DISC SERIES
Scan parameter-cervical
disc
Acquisition
Scan series
1&2
Axial
Sequence
range 3
Axial Spiral
pitch =
1.5
Slice
Thic
kne
ss
3 mm
2 mm
Table
Moveme
nt
3 mm
3 mm
mAs
~100-150
~100-150
IV
contra
st
kV
algorithm
Rotation
Time
140
bone + soft
tissue
adult
head
0.75-1.5
secon
d
140
bone + soft
tissue
adult
head
0.75-1.5
secon
d
windowing
Window
Width
Centre
Bone range 1 - 3
2000-3000
200-500
150-450
30-50
image reproduction
criteria
anatomy covered
range 1
Axial Spiral
pitch =
1.5
Slice
Thi
ckn
ess
3 mm
Table
Move
ment
4.5 mm
mAs
~200-250
kV
algorithm
Rotation
Tim
e
140
bone +
soft
tissue
adult
body
0.75-1.5
seco
nd
IV
cont
rast
windowing
Window
Width
Centre
Bone range 1
2000-3000
200-500
150-450
30-50