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

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52 Revised 7/22/09 (Gentry/Ranallo) Stealth - Stereotactic Head: (Whole Brain Treatment Planning) (Protocol – Adult: # 1.10 – Pediatric: # 11.11 & 11.12) Billing: Setup: Contrast: Scan Factors: General Notes: 1. CT Stereotactic 2. Contrast if used 1. Patient Supine on table top 2. AP and lateral scouts 3. No gantry angle 4. Using the lasers, line up patient so that the canthomeatal line is perpendicular to the CT table. This may require you to tilt the patients head either up on down slightly. 5. Scan from the hard palate to the top of the head 1. Adult: 150 ml of 240 mg/dl non-ionic contrast @ 0.6 ml/sec (4.2 minutes) 2. Peds: 1 ml / pound (2 ml/kg) of 240 non-ionic contrast @ 0.6 ml/sec 3. Begin scanning as soon as contrast injection is finished Mode Axial Time 1 sec Mode 1.25 @ 8i - Interval 10.0 KVP 120 mA 250 Algorithm Standard SFOV Head DFOV 22 to 25 1. If there is ANY patient motion, start the scan over. 2. All images should be networked to ALI Store. 3. Archive only the axial images to the MOD that goes to the surgeon. 4. Technical support is available 24 hours and day, 7 days a week at 800-595-9709.
Sinuses (Diagnostic): (Adult and Pediatric) (Protocol – Adult: # 2.7 – Pediatric: # 12.13 &12.14) Billing: Setup: Contrast: Patient Age: DFOV: 1. CT Sinus without, or with, or with and without 2. Contrast if used 53 Revised 7/22/09 (Gentry/Ranallo) 1. Patient Supine, AP and lateral scouts, no gantry angle 2. Extend the scouts to include aortic arch for smart prep if the exam is to be done with contrast. 3. 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). The tip of the nose and the both zygomatic bones must be on the scan. 4. Scan from the bottom of maxillary teeth to the top of the frontal sinuses (see below) 5. Note: If the scan is protocoled as a “with contrast” scan, start the scans at the genu of mandible 6. Use axial CT scan factors if a coronal plane scan is ordered. 1. Adults: 100 ml of 240 mg/ml nonionic contrast media; Pediatrics: 1 ml/lb (2 ml/kg) of 240 nonionic contrast media. 2. Injection Rate: Adults: 3.5 ml/sec; Pediatric: 0.6 to 2.5 ml/sec 3. Smart prep over the aortic arch (use cavernous sinus if arch cannot be seen) 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) Preferred 14 cm (Range 14-16 cm) Recons & Reformats: 1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats (see below) Sagittal: Through both orbits. Be sure to include both TMJs. Coronal: 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 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 2Dreformats using the standard 1.25 mm images (Recon 1) only from the contrast series and also do 2 mm x 2 mm reformats using bone images (Recon 2) from the non-contrast series.
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Vascular Imaging: Stroke Deluxe: (A
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Suggestions for ROI Placement 133 R
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1. CTA (High-res COW) 2. CTA (Strok
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CT Protocols: (Brain, ENT, Spine, Vascular) - Department of Radiology

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