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

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90 Revised 7/22/09 (Gentry/Ranallo) Brachial Plexus: (Routine) (Protocol – Adult: # 3.1 – Pediatric: # 13.1) (Feet First) (Protocol – Adult: # 3.2 – Pediatric: # 13.2) This protocol is the same as the routine neck CT with the following exceptions: Billing: Modifications: 1. CT Neck without, or with, or without and with 2. Contrast if used 1. Inject the contralateral arm from the brachial plexus of interest. 2. CT scan delay after arrival of contrast in aortic arch: - Adult: 15 sec (all scanners), - Peds: 10 sec (all scanners), 3. DFOV: Range 26-32 cm. - Extend DFOV laterally to include bilateral humeral heads of the shoulders 4. 2D Reformations in addition to standard routine neck reformations (see below)

91 Revised 7/22/09 (Gentry/Ranallo) Cervical Spine: (Adult Routine) (Protocol: # 3.5) Billing: Setup: DFOV: 1. CT cervical spine without, or with, or without and with 2. Contrast if used 1. Patient Supine, AP and lateral scouts, no gantry angle 2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used. 3. Patient Positioning: - Warning: Do not flex or extend the neck if there has been recent spine trauma or if the patient is in a c-spine trauma collar. - If no recent trauma, 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. - The shoulders should be pulled down as much as possible 4. Scan from the top of the sella to the bottom of T2 Preferred 17 cm (Range 16-18 cm) Contrast: 1. Injection parameters: 2. Volume: 100 ml of 240 mg/ml nonionic contrast (use 150ml of 240mg/ml if a CT of the head will also be obtained). 3. Injection Rate: Adults: 3.5 ml/sec 4. Smart prep over the aortic arch. 5. CT scan delay after arrival of contrast in aortic arch: 10 sec (8 slice scanners), 15 sec (16 slice scanners), 20 sec (64 slice scanners) Recons & Reformats: 1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes. 2. You must include the entire larynx and hyoid bone on the sagittal 2D reformats (see below) 3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2) 4. If this is a “with & without” contrast study: Do not do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series. 5. Do not send the 0.625 mm (Recon 2) bone images to PACS.

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

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