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

Temporal Bone: (W/O & W/ Contrast) or (W/ Contrast Only):
(Protocol – Adult: # 2.11 – Pediatric: # 12.20 & 12.21)
66 Revised 7/22/09 (Gentry/Ranallo)
Billing:
Setup:
DFOV:
Exam:
1. CT Temporal Bone (without and with)
2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry angle:
2. Extend the scouts to include aortic arch for smart prep.
3. Only use 16 and 64 slice scanners
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 head CT protocol).
1. Posterior Fossa: Preferred 20 cm (Range 18-22 cm)
2. TB: 9.6 cm
Part 1: Temporal Bone CT Without Contrast
1. Use the same protocol as described in the Temporal Bone W/O Contrast protocol
2. This includes axial Recon 1, 2 and 3; the additional Retro recons of soft tissue and of
bone; and all the reformatted 1 x 1 cm images of the temporal bones.
Part 2: Temporal Bone Examination With Contrast
1. Inject contrast and then obtain standard algorithm 1.25 mm scans with a 0.75 mm
interval from the bottom of C1 to 1 cm above the top of temporal bone.
2. Contrast Usage: Adults: 150 ml of 240 mg/ml nonionic contrast media; Pediatrics: 1 ml/lb
(2 ml/kg) of 240 nonionic contrast media.
3. Injection Rate: Adults: 3.5 ml/sec; Pediatric: 2.0 to 2.5 ml/sec
4. Smart prep over the aortic arch and begin scanning 30 seconds (adults) or 15 seconds
(pediatrics) after arrival of contrast in the arch.
5. Reconstruct the 1.25 mm axial slices into 2 mm x 2 mm images of the posterior fossa
(axial, coronal, and sagittal) using an 18-22 cm DFOV with standard algorithm only.
Patient Age: 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)
Reformats:
1. Part 1: Do 1 mm by 1 mm 2D-reformats in the coronal, Stenver’s, and Pöschl planes
2. Part 2: Do 2 mm by 2 mm 2D-reformats in the axial, coronal, and sagittal planes
Exam:
Temporal Bone CT With Contrast Only
1. Use the same technique as above except do Part 2 first then do Part 1 following the
contrast study.