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

95 Revised 7/22/09 (Gentry/Ranallo)
Lumbar Spine: (Adult Routine) (Protocol: # 7.1)
Billing:
Setup:
DFOV:
1. CT lumbar 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. Non-contrast unless otherwise protocoled
4. Scan from the top of T12 to the top of S2
5. Post myelography patients: Please remember to roll the patient 360 degrees before
scanning to distribute the contrast evenly in the spinal canal.
Preferred 17 cm (Range 16-18 cm)
Contrast:
1. Injection parameters:
2. Volume: 100 ml of 240 mg/ml nonionic contrast (use 150 ml of 240 mg/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)
For Large Patients:
Increase scan time to 1.0 sec on CT1, CT3, CT4, and ER CT.
Raise kV to 140 kV on CT2, East & RP CT.
For VERY large patients, increase scan time to 1.0 sec and increase kV to 140 kV
on CT1, CT3, CT4, and ER CT.
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.
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)
3. 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 2mm x 2mm reformats using the bone 0.625 mm images (Recon 2)
from the non-contrast series.
4. Do not send the 0.625 mm (Recon 2) bone images to PACS.