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

75 Revised 7/22/09 (Gentry/Ranallo)
Neck: (Routine) (Protocol – Adult: # 3.1 – Pediatric: # 13.1)
Billing:
Setup:
DFOV:
Contrast:
(Feet First) (Protocol – Adult: # 3.2 – Pediatric: # 13.2)
1. CT Neck without, or with, or without and with
2. Contrast if used
1. Patient supine, AP and lateral scouts from sella to mid chest, no gantry angle
2. Extend the scouts to include aortic arch for smart prep.
3. Have the patient remove any dentures or removable teeth, please place the
shoulders as low possible
4. Start the scan at the carina and scan to the top of the orbit
5. 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).
6. Do angled views at 2.5 mm 4i for 8 slices at 2 different angles if there is lots of
artifact from dental fillings or metal hardware (see below)
7. Note: see page 138 for protocol modifications if done as combined study with
body/chest/abdomen/pelvis CT)
Preferred 30 cm (Range 26-30 cm)
1. Adults: 100 ml of 300 mg/ml nonionic contrast media, Pediatrics: 1 ml/lb (2 ml/kg) of
300 non-ionic contrast media.
2. Use a 50 ml saline chaser in adults and a 10-25 ml saline chaser in pediatrics.
3. Injection Rate: Adults: 3.0 ml/sec; Pediatric: 2.0-2.5 ml/sec
4. Smart prep over the aortic arch.
5. CT scan delay after arrival of contrast in aortic arch:
Adult: 10 sec (4-8 slice scanner), 15 sec (16 slice scanner), 20 sec (64 slice scanner)
Peds: 5 sec (4-8 slice scanner), 8 sec (16 slice scanner), and 10 sec (64 slice scanner)
Reformats and Recons:
1. For Adult scans: There is a soft tissue 2.5 mm slice thickness for Recon 1, a bone plus 1.25 mm
slice thickness for Recon 2, and a soft tissue 1.25 mm slice thickness for Recon 3. Only send
Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 3
for the soft tissue reformats. Use the 1.25 mm slices in Recon 2 for the bone reformats.
2. For Pediatric scans: There is a soft tissue 1.25 mm slice thickness for Recon 1, a bone plus
1.25 mm slice thickness for Recon 2, and a bone plus 0.625 mm slice thickness for Recon 3.
Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in
Recon 1 for the soft tissue reformats. Use the 0.625 mm slices in Recon 3 for the bone
reformats.
3. Do 2 mm by 2 mm 2D-Reformations in the coronal and sagittal planes