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

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.