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

Pituitary Gland and Cavernous Sinus:
(Protocol – Adult: # 2.6 – Pediatric: # 12.11 & 12.12)
48 Revised 7/22/09 (Gentry/Ranallo)
Billing:
Setup:
Exam:
DFOV:
For Part 2:
1. CT Head with and without contrast; CT Sella with contrast
2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry angle
2. Extend the scouts to include aortic arch for smart prep.
3. Use 64 slice scanners if possible
4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see below).
Part 1: CT Head Without Contrast (do as in routine CT head)
Part 2: Pituitary CT with Contrast (as outlined below)
- Use a DFOV of approximately 14 cm (include the orbit and the sella
- Perform helical axial scans between yellow lines as diagramed at bottom of page
- Use a bolus contrast injection as listed below:
1. Adults: 150 ml of 240 mg/ml nonionic contrast at 3.5 ml/sec
2. Pediatrics: 1 ml/lb (2 ml/kg) of 240 nonionic at 2.0 to 2.5 ml/sec
- Smart prep over the aortic arch and begin scanning 15 seconds (adults) or 8
seconds (pediatrics) after arrival of contrast in the arch
- Begin Part 3 when all of contrast is in.
Part 3: CT Head With Contrast (do as in routine CT head)
Head:
Pituitary:
Preferred 20 cm (Range 18-22 cm)
14 cm
1. Only send the Standard 1.25 mm (Recon 1) images to PACS. Do not send the
Recon 2 bone images to PACS.
2. Do 2 mm x 2 mm 2D-reformats using both the standard 1.25 mm (Recon 1) images
AND the bone 0.625 mm (Recon 2) images as outlined below.