CT Protocols: (Brain, ENT, Spine, Vascular) - Department of Radiology

37 Revised 7/22/09 (Gentry/Ranallo)
Maxillofacial Trauma: (Routine)
(Protocol – Adult: # 2.5a – Pediatric: # 12.9 & 12.10)
Billing:
Setup:
1. CT Maxi-face without, or with, or with and without
2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle
2. Extend the scouts to include aortic arch for smart prep.
3. Remove all metallic and high-density objects from the scanning area.
4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus and the EAC is perpendicular to the CT tabletop (see head CT protocol).
5. Scanning begins just below the genu of the mandible to the top of the frontal sinuses
Contrast:
Patient Age
1. Routine: w/o contrast. Use the following injection parameters if done w/ contrast.
2. Adults: 100 ml of 240 mg/ml nonionic contrast (use 150ml of 240mg/ml if a CT head
will also be obtained); Pediatrics: 1 ml/lb (2 ml/kg) of 240 non-ionic contrast.
3. Injection Rate: Adults: 3.5 ml/sec; Pediatric: 2 ml/sec
4. Smart prep over the aortic arch and begin scanning 15 seconds (adults) or 8
seconds (pediatrics) after arrival of contrast in the arch
: Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years)
2. Infant: (0 – 3 years)
DFOV:
Preferred 17.2 cm (Range 15-18 cm)
Recons & Reformats:
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats as shown in
the image below
Oblique Sagittal: Through each orbit parallel to the optic nerves.
Sagittal:
Coronal:
Through both orbits. Be sure to include both TMJs.
From the anterior aspect of the superior orbital rim through the
sella. Be sure to include all of the TMJ.
2. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using
both the standard 1.25 mm images (Recon 1) AND the bone images (Recon 2)
3. If this is a “with & without” contrast study: Do not do Recon 2 on the contrast scan. Do
2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series
AND also do 2mm x 2mm reformats using the bone images (Recon 2) from the noncontrast
series.