CT Protocols: (Brain, ENT, Spine, Vascular) - Department of Radiology
CT Protocols: (Brain, ENT, Spine, Vascular) - Department of Radiology CT Protocols: (Brain, ENT, Spine, Vascular) - Department of Radiology
32 Revised 7/22/09 (Gentry/Ranallo) Smart Prep Prep Over mA Monitoring Delay (sec) Monitoring ISD (sec) Enhancement Threshold Diagnostic Delay (sec) Aortic Arch 40 10.0 2.0 50 6.0 Orbit: Routine Pediatric Infant (0 – 3 yr) Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8 Scan Type Helical Helical Helical Helical Helical Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8 Detector Coverage (mm) Beam Collimation (mm) 10 10 10 20 10 Detector Rows 16 16 16 16 8 Pitch 0.562 0.562 0.562 0.531 0.625 Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25 Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25 Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25 Interval (mm) 0.75 0.75 0.75 0.625 0.75 Scan FOV Head Head Head Small Head Head kV 80 80 80 80 80 Smart mA/ Auto mA Range 110-570 80-390 110-550 100-520 80-390 Noise Index 5.1 5.1 5.1 5.1 5.1 (Manual mA) 370 260 360 340 260 Recon 1: DFOV 15 15 15 15 15 Recon Type Standard Standard Standard Standard Standard WW/ WL 300/0 300/0 300/0 300/0 300/0 Recon Option Plus Plus Plus Full Plus Recon Option Recon 2: IQ Enhance DFOV 15 15 15 15 15 Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300 Recon Option Plus Plus Plus Full Plus Recon Option IQ Enhance Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25 Interval (mm) 0.75 0.75 0.75 0.625 0.75 Recon 3: DFOV 15 15 15 15 Recon Type Bone Plus Bone Plus Bone Plus Bone Plus WW/ WL 3000/300 3000/300 3000/300 3000/300 Recon Option Plus Plus Plus Full Recon Option Non-Contrast or Contrast CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT IQ Enhance Slice Thickness (mm) 0.625 0.625 0.625 0.625 Interval (mm) 0.375 0.375 0.375 0.312
33 Revised 7/22/09 (Gentry/Ranallo) Orbit: (With and Without Valsalva) (Protocol – Adult: # 2.2 – Pediatric: # 12.3 & 12.4) Billing: Setup Info: 1. CT Orbit with or with and without 2. Contrast 1. Monitored Exam: ENT attending or fellow 2. Patient Supine, AP and lateral scouts, no gantry angle 3. Extend the scouts to include aortic arch for smart prep. 4. Patient Positioning: Tilt the patients head so that a line connecting the lateral canthus of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). You may need to put a foam pad under the occiput to get the head in this position. 5. Ask the patient to look straight ahead and hold their eyes in a very still position. 6. Start the scans at the infraorbital rim and scan through the top of the orbit 7. Always done following either a routine orbit CT with contrast or a vascular mass CT of the orbit with and without contrast Exam: Part 1: Routine Orbit CT with contrast or Orbit Vascular Mass CT without and with contrast Part 2: Valsalva Protocol (as below) - Use routine orbit scan factors (but only Recon 1 – No bone images) - To be monitored by ENT attending or ENT fellow if possible - If there is any indication of increased intra-orbital or intra-ocular pressure, the radiologist should 1st clear this procedure with the ordering ophthalmologist - First rehearse the maneuver with the patient - Ask the patient to take a deep breath and Valsalva for 15 seconds (do not do CT scans at this point) - Have the patient take another deep breath, then - Do Valsalva maneuver again. - Begin 1.25 mm helical scans through entire orbit 5 seconds after the start of the 2 nd Valsalva maneuver - Acquire 1.25 mm helical images in axial plane using just the standard algorithm (no bone algorithm) DFOV: Reformats: Preferred 14 cm (Range 14-16 cm) 1. Do the routine 2D orbital reformations for Part 1. 2. Do additional 2 x 2 mm 2D-reformations (soft tissue only) from the post Valsalva images in Part 2 in the coronal and bilateral oblique sagittal planes as shown below.
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32 Revised 7/22/09 (Gentry/Ranallo)<br />
Smart Prep<br />
Prep Over<br />
mA<br />
Monitoring Delay<br />
(sec)<br />
Monitoring<br />
ISD (sec)<br />
Enhancement<br />
Threshold<br />
Diagnostic Delay<br />
(sec)<br />
Aortic Arch 40 10.0 2.0 50 6.0<br />
Orbit: Routine<br />
Pediatric Infant (0 – 3 yr)<br />
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS V<strong>CT</strong> 64 GE LS 8<br />
Scan Type Helical Helical Helical Helical Helical<br />
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8<br />
Detector Coverage (mm)<br />
Beam Collimation (mm)<br />
10 10 10 20 10<br />
Detector Rows 16 16 16 16 8<br />
Pitch 0.562 0.562 0.562 0.531 0.625<br />
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25<br />
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25<br />
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25<br />
Interval (mm) 0.75 0.75 0.75 0.625 0.75<br />
Scan FOV Head Head Head Small Head Head<br />
kV 80 80 80 80 80<br />
Smart mA/ Auto mA Range 110-570 80-390 110-550 100-520 80-390<br />
Noise Index 5.1 5.1 5.1 5.1 5.1<br />
(Manual mA) 370 260 360 340 260<br />
Recon 1:<br />
DFOV 15 15 15 15 15<br />
Recon Type Standard Standard Standard Standard Standard<br />
WW/ WL 300/0 300/0 300/0 300/0 300/0<br />
Recon Option Plus Plus Plus Full Plus<br />
Recon Option<br />
Recon 2:<br />
IQ Enhance<br />
DFOV 15 15 15 15 15<br />
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus<br />
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300<br />
Recon Option Plus Plus Plus Full Plus<br />
Recon Option<br />
IQ Enhance<br />
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25<br />
Interval (mm) 0.75 0.75 0.75 0.625 0.75<br />
Recon 3:<br />
DFOV 15 15 15 15<br />
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus<br />
WW/ WL 3000/300 3000/300 3000/300 3000/300<br />
Recon Option Plus Plus Plus Full<br />
Recon Option<br />
Non-Contrast or Contrast<br />
<strong>CT</strong> 1 <strong>CT</strong> 2 <strong>CT</strong> 3 <strong>CT</strong> 4 & ER <strong>CT</strong> East & RP <strong>CT</strong><br />
IQ Enhance<br />
Slice Thickness (mm) 0.625 0.625 0.625 0.625<br />
Interval (mm) 0.375 0.375 0.375 0.312
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