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

86 Revised 7/22/09 (Gentry/Ranallo)
Neck: (Parathyroid Adenoma) (Protocol – Adult: # 3.4 – Pediatric: # 13.4)
Billing:
Setup:
DFOV:
1. CT Neck with
2. Contrast
1. Patient Supine, AP and lateral scouts from sella to mid chest, no gantry angle
2. Only do on a 64 slice scanner
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 head CT protocol).
4. Remove any dentures or removable teeth; please place the shoulders as low possible
1. Part 1: 22 cm (adults), 20 cm (peds 3-6 y/o), 18 cm (peds 0-3 y/o)
2. Part 2: (as in routine neck CT)
Exam: Part 1: Arterial Phase of Lower Neck
1. Algorithm: Standard only
2. Scan Area: Start scans at the carina and scan to the bottom of the upper teeth
3. Contrast: Adult: 100 ml of Iohexol 300 with a 50 ml saline chase
Peds: 1 ml/lb (2 ml/kg) of Iohexol 300 with a 10-25 ml saline chase
4. Injection Rate: Adult: 4 ml per sec
Peds: 2.0-2.5 ml/sec
5. Smart Prep: Over aortic arch (initiate scan at the entry of contrast in the aortic arch)
6. Begin Part 2: Do a routine Neck CT Protocol immediately following Part 1 with the
following modifications.
Part 2: Routine Neck CT with Contrast (with the following modifications)
1. Perform a Routine Neck CT Protocol using the same scan factors as in that protocol
2. Do not use any CT scan delay but start scanning the routine neck CT as soon as
Part 1 is finished.
3. Do angled views if necessary
Recons & Reformats:
Part 1: A. Sagittal and coronal 2D reformations using standard algorithm images only
Part 2: A. 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.
B. 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.
C. Do 2 mm by 2 mm 2D-Reformations in the coronal and sagittal planes