CT Protocols 1
CT Protocols
Chest
Anatomic region : chest
Positioning supine, upper extremities over the head , feet
first.
- Scout view: AP & lat, length (350 - 500 ) mm, Angle 0°, 90°
- Scan area: from Apex to C. ph. Angle
Contrast media if indicated by the radiologist.
IV (50 c.c - 100 c.c)
Oral :NO
Rectal : No
Injection rate :2.0 C.C/sec
Scan delay time : 35.0 sec
Scan type : helical, SL. Th. 7.5mm
Viewing (photography): ST (350-450)ww (20-40)wl lung
(750-850)ww/ (-600___-800)
Reconstruction : If indicated
Sag:/
Cor:/
Axial:/
3D display:/
Special instruction :Raw data must be saved
Remarks 1.No metal things on interested area
2.Scanning after full inspiration
3.Bone window is necessary in trauma cases R/O
fractures of in malignancy R/O bone diffict.
4.Print mediastinal and lung
window
Chest with H.R
Anatomic region :chest
Positioning : supine, upper extremities over the head , feet
first.
Scout view: AP& lat, length ( 350-500 )mm, Angle 0°.
Scan area: from lung apex to C. ph angle
Contrast media: No
IV:No
Oral:No
Rectal:No
Injection rate:No
Scan delay time:No
Scan type : axial SL Th 1.25 mm interval 10mm
Viewing (photography) : M.W (350-450) ww (20-40)wllung. w(750-850) ---(-600--- -800) wl
Reconstruction:
Sag:
Cor:
Axial:
3D display:
- Special instruction :Raw data must be saved.
- Remarks :1.No metal things on interested area.
2.Print mediastinal and lung window.
3.Scans are performed with suspended respiration
as per tape instruction
Adrenal Gland
- Anatomic region: Adrenals
Positioning : supine, upper extremities over head, feet first
Scout view: AP& lat, length (200-300)mm angle 0°
Scan area: suprarenal gland
From the 10 dorsal vertebra to the 2 lumbar vertebra
Contrast media :if indicated
IV: 100 c.c
Oral: No
Rectal:No
Injection rate :2.0 ml / sec
Scan delay time : 50 sec
Scan type : Helical SL Th (2-4)mm
Viewing ( photography ): ST (300-400)ww (20-40)wL
- Reconstruction : if indicated by radiologist
Usually after 12 minutes to 15 minutes
Sag:
Cor:
Axial:
3D display:
Special instruction :Raw data must be saved
Remarks 1.stop breathing after inspiration
Kidnys
- Anatomic region : kidneys
- Positioning: supine, upper extremities over head, feet first
Scout view: AP& lat, length (200-300)mm, angle 0°
- Scan area : kidneys
Contrast media if indicated by radiologist
IV: 100c.c
Oral
Rectal
Injection rate :2.0 cc/ sec
Scan delay time : 40 sec
Scan type : Helical SL Th (3-5)mm
Viewing (photography) S.T (300-400)ww (20-40)wl
Reconstruction :if indicated by radiologist
Usually after 12 minutes to 15 minutes Imaging of all the urinary tract
Sag :
Cor :
Axial :
3D display:
Special instruction : Raw data must be saved
Remarks : stop Breathing after inspiration
Pancreas
Anatomic region : pancreas
- Positioning : supine, upper extremities over head , feet fir
- Scout view: AP& lat, length (250-350)mm, angle 0°
-Scan area: pancreas (Abdomen)
From the 10 dorsal vertebra to the 3 lumbar vertebra
Contrast media : if indicated
IV: 100c.c
Oral: Some doctors preferring contrast 1000 c.c And some doctors preferring just500 water
Rectal:No
- Injection rate: 2.0 c.c/sec
Scan delay time : 40 sec
Scan type : Helical SL Th (3-5)mm
- Viewing ( photography) ST (300-400)ww ( 20-40)wl
Reconstruction :
Sag:
Cor:
Axial:
3D display:
- Special instruction : Raw data must be saved
- Remarks : stop breathing after full inspiration.
Abdomen
Anatomic region: Abdomen
-Positioning : supine, upper extremities over head, feet first
Scout view: AP& lat, length (350-500)mm, angle 0° ,90°
Scan area: from lower chest to iliac creast.
Contrast media :if indicated by radiologist
IV: (100-120) c.c
Oral:1000 c.c
Rectal:No
Injection rate :2.0 c.c/ sec
- Scan delay time : 30 sec for Arterial phase& 70 sec for
veinus phase
- Scan type: Helical Sl .Th. 7.5 mm
- Viewing (photography ) S.T (300-400)ww - ( 20-50)wl
Reconstruction :
Sag
Cor
Axial
3D display:
-Special instruction : Raw data must be saved
- Remarks 1.No metal things on interested area.
2.Oral contrast must be drinked during 30 min
before scanning.
3.Scanning after take full inspiration.
4.Bone window printed if indicated bone diffict.
5.last cup of oral contrast should drinked on the
C.T Scan table.
Liver (hypovascularized metes)
- Anatomic region: Liver
Positioning : supine, upper extremities over head, feet first
Scout view: AP& lat, length (300-400)mm, 0°
Scan area: Liver
Contrast media :
IV:100c.c
Oral:if indicated
Rectal: No
Injection rate: 2.0 c.c /sec
Scan delay time : 60 sec (portal veinous phase)
Scan type : Helical SL Th 7.5 mm
Viewing ( photography S.T (300-400)ww ( 20-40) wl
- Reconstruction:
Sag
Cor
Axial
3D display :
- Special instruction: Raw data must be saved
- Remarks : Stop Breathing after full inspiration.
Liver (Lesions of unknown origin )
Anatomic region : Liver
Positioning : supine, upper extremities over head, feet first
Scout view: AP& lat, length (300-400)mm, angle 0°
- Scan area : liver
Contrast media:
IV:100c.c
Oral: if indicated
Rectal
- Injection rate 4.0 c.c /sec
- Scan delay time : 25 sec Arteral phase Preferably work with smart prep 70 sec veinous phase
- Scan type : Helical SL Th 7.5 mm Some doctors prefer a follow-up work in 3-5 minutes
- Viewing (photography): S.T (300-400) ww ( 20-40)wl
- Reconstruction:
Sag
Cor
Axial
3D display:
- Special instruction Raw data must be saved
Remarks : Stop Breathing after full inspiration
Liver( haemangioma )
Anatomic region : Liver
Positioning supine, upper extremities over head, feet first
Scout view: AP& lat, length (300-400)mm, angle 0°
Scan area: liver
without & with i.v contrast
Contrast media :
IV: 100 c.c
Oral:if indicated
Rectal :No
Injection rate : 4.0 c.c/ sec
Scan delay time 15-20 sec
Scan type : Helical SL Th 2.5 mm
Viewing (photography ) :S.T ( 300-400)ww ( 20-40)wl
Reconstruction :
Sag
Cor
Axial
3D display:
Special instruction : Raw data must be saved
Remarks : 1. Stop breathing after full inspiration
Neck
Anatomic region : Larynx
Positioning supine, upper slightly extremities over head
feet first
Scout view: AP& lat, length (250-300)mm, angle 0°
Scan area: from vallecula to bottom of cricoid cartilage
Contrast media if indicated by radiologist
IV: 50c.c
Oral: No
Rectal: No
Injection rate:2.0 c.c /sec
Scan delay time : 30-35sec
Scan type : Helical SL Th ( 3-5 ) mm
Viewing (photography ) S.T (250-350) ww ( 20-40)wl
Reconstruction : if indicated by radiologist
Sag
Cor
Axial
3D display
Special instruction: Raw data must be saved
Remarks : Scanning swallowing
Pulmonary CTA
- Anatomic region : Chest
- Positioning : supine, upper extremities over head, feet first
-Scout view: AP& lat, length (350-450)mm, angle 0°
- Scan area: from apex to C.ph angle
Contrast media:
IV:20-50 c.c
Oral: No
Rectal: No
- Injection rate:5.0 c.c /sec
- Scan delay time : (6-11sec) Preferably work with TestBolus(TimeBolus)
- Scan type : Helical SL Th 0.6-1.25 ) mm
- Viewing (photography S.T (300-350) ww ( 20-40)wl
lung w (700-800) ww (-600- -800)
Reconstruction :
Sag
Cor
Axial
3D display
Special instruction : Raw data must be saved
Remarks : Scanning after full inspiration
Thoracic & Abdominal CTA
- Anatomic region :from apex to iliac creast
- Positioning :supine, upper extremities over the head, feet first.
- Scout view: AP& lat , length (300- 400 )mm, Angle 0°
- Scan area : from chest apex to C. ph angle
Contrast media :
IV:50-100 c.c
Oral: No
Rectal: No
Injection rate: 5.0 c.c/sec
Scan delay time : (16-22) sec
Preferably work with smart prep
Scan type : Helical SL Th (1-3) mm
Viewing (photography ) S.T (300-400) ww ( 20-40)wl
Reconstruction :
Sag
Cor
Axial
3D display:
Special instruction :Raw data must be saved.
Remarks : Scanning after full inspiration
Renal CTA
- Anatomic region : Renals
Positioning : supine, upper extremities over head, feet firs
Scout view: AP& lat, length (300-400)mm, angle 0°
Scan area : from lower chest to level of iliac creast
Contrast media if indicated by radiologist
IV: 80-100 c.c
Oral :No
Rectal : No
- Injection rate: 5.0c.c/sec
Preferably work with smart prep
Scan delay time : (16-22) sec
Scan type : Helical SL Th (1-2)mm
Viewing ( photography ): S.T (300-400)ww (20-40)wl
Reconstruction:
Sag
Cor
Axial
3D display:
- Special instruction : Raw data must be saved
Remarks: Scanning after full inspiration
Abdominal aorta& L.L CTA
Anatomic region: Abdomen & L.L CTA
Positioning supine, upper extremities over head, feet first
Scout view: AP& lat, length (1000-1300)mm, angle 0°
Scan area: from lower chest to end of the foot.
Contrast media :if indicated by radiologist
IV:(80-120) c.c
Oral: No
Rectal: No
- Injection rate
using first phase 5.0c.c /sec second phase 3.0c.c/sec
Scan delay time : (15-20 )sec
Preferably work with smart prep
Scan type : Helical Sl Th (1-3) mm
- Viewing (photography) S.T (300-400)ww - (20-50)wl
- Reconstruction:
Sag
Cor
Axial
3D display:
- Special instruction : Raw data must be saved
Remarks : Scanning after full inspiration and quite breathing
When we reach a pelvis.
Body CT
Anatomic region: Chest + Abdomen + Pelvis
Positioning : supine, upper extremities over head , feet first
Scout view: AP& lat, length (750-100)mm, angle 0°
Scan area from chest to pubic bone
Contrast media if indicated by radiologist
IV: 100 120c.c
Oral: 1000c.c
Rectal :if needed
Injection rate: 2.0c.c/sec
Scan delay time : (30-40 ) sec for chest & (60-70)sec abdomen+ Pelvis
Scan type : Helical SL Th 7.5 mm
Viewing (photography) Abdomen S.T (300-400)ww
(20-40)wl (-600 --800)
Reconstruction:
Sag
Cor
Axial
3D display:
Special instruction : Raw data must be saved
Remarks : 1.Scanning after full inspiration
2.Patient should be drink oral contrast during hrs before scanning and should be drink the last cup on C.T room.
Tempro Mandibular Joint
Anatomic region: T.M.J
Positioning supine, ( 1.O.M line) parallel to x-ray beam,head first
Scout view: lateral, length ( 100-200 mm), angle 0 degree.
Scan area: ( to cover T.M.J)
Contrast media : as indicated by the radiologist.
IV: 50 cc
Oral: No
Rectal : No
- Injection rate: 2.0cc/sec
- Scan delay time : 30 sec
- Scan type : axial slice thickness ( 1-2 mm ) .
Viewing ( photography) S.T ( 350-450 ww) ( 35-50wL),
B.W (2000-4000ww) ( 500-700wl)
- Reconstruction: if indicated by the radiologist.
Sag yes
Cor yes
Axial
3D display yes
- Special instruction : raw data must be saved.
- Remarks:
1. call patient don't move.
2. remove all metal thing from scan area .
3. open and closed month if indicated
Temporal bone
- Anatomic region : temporal bone
- Positioning supine, I.O.M parallel to x-ray beam, head firs.
Scout view: AP and lateral, length ( 150-250mm) angle 0 degree.
- Scan area 5 mm above roof of (E.Am) through temporal bone
Contrast media:
IV: as indicated by the radiologist ( 50cc)
Oral: No
Rectal:No
Injection rate:2.0cc/sec
Scan delay time: 1 minute
Scan type : axial slice thickness ( 1-2mm ).
Viewing (photography ): S. T ( 150-250ww), ( 35-50wl), B.W (2000-4000 ww), ( 500-700 wl),
Reconstruction : if indicated
Sag
yes
Cor
: yes
Axial
3D display : yes
Special instruction : raw data must be saved .
Remarks:
1- call patient don't move
2- remove all metal thing from scan area.
3- In control scan if indicated scan area from styloid process to jugular bulb
Anatomic region: Dorsal spine
Positioning supine, upper extremities extended up, feet first
- Scout view: AP & lateral, length (500-750mm), angle 0 degree.
Scan area: from D1 to D 12
Contrast media:
IV
Oral
Rectal
Injection rate
Scan delay time:
Scan type : Helical or axial slice thickness ( 2-5mm)
Viewing ( photography) ST. (350-450ww) ( 35-56wl)
BW( 1500-2000 ww) ( 300-500wl)
- Reconstruction: if indicated to the radiologist
Sag: yes
Cor: yes
Axial: yes
3D display yes
- Special instruction : raw data must be saved.
- Remarks:
1. call patient don't move
2. move all metal thing from scan area.
3. Stop breathing during scanning.
4. Cl should be included in scout view for proper counting.
5. The image should be include with a reference image (scout)
Spine
Anatomic region: lumbar spine
Positioning supine, upper extremities extended over head, knee flexed.
Scout view: AP and lateral, length (350-750mm) angle 0 degree.
- Scan area: from L1 to L5
Contrast media :
IV
Oral
Rectal
Injection rate
Scan delay time:
Scan type : axial or helical ( 2-5mm) slice thickening.
Viewing (photography ):
Reconstruction.
Sag:if indicated to the radiologist
Cor:
Axial:
3D display:
Special instruction : raw data must be saved.
Remarks:
1. call patient don't move.
2. move all metal thing from scan area.
3Protocols. To R/O disc prolapse, thin slices to cover the disc area with special angulations to the beam to be parallel to intra vertebral disc.
4. The images print with reference image (scout)
Spine
- Anatomic region: cervical spine
Positioning supine, neck extended of shoulder down, head first.
Scout view: AP & lateral length (350-450mm) , angle 0 degree.
Scan area: area of interest from C1-C7
Contrast media :
IV:
Oral:
Rectal:
- Injection rate
Scan delay time :
Scan type : Helical slice thickening (1-3 mm)
Viewing ( photography ) : S.T ( 250-350ww), BW ( 1500- 2000)- (300-500wl)
Reconstruction : yes
Sag: yes
Cor:yes
Axial: yes
3D display :yes
Special instruction : raw data must be saved.
Remarks:
1. call patient don't move.
2. move all metal thing from scan area.
3. To R/O disc prolapse, thin slices to cover the disc area with special angulations to the beam to be parallel to intra vertebral disc.
Sella tourcica (pituitary)
Anatomic region: pituitary.
- Positioning supine I.O.M parallel to x-ray beam head first.
Scout view: AP lateral, length (150-200mm), Angle 0 degree.
Scan area: from tuberculusm to dorsum sella
Contrast media:
IV : if indicated by the radiologist ( 50 cc)
Oral : No
Rectal : No
- Injection rate(Rapid I.V bolus ) ( 3-4 cc/sec )
- Scan delay time : (30 sec.)
- Scan type: axial (1-2mm ) slice theckeness.
Viewing (photography ) ST ( 150-250ww ) ( 35-100wl).
- Reconstruction: given more information ( as indicated ).
Sag:yes
Cor: yes
Axial
3D display:
Special instruction : raw data must be saved .
-Remarks:
1- call patient don't move.
2- move all metal thing from scan area.
Orbits
Anatomic region: Orbits
Positioning Supine, I.O.M parallel to x-ray beam, head first.
Scout view: AP and lateral, length (100-150mm), Angle 0 degree.
Scan area: infra orbital ridge to supra orbital ridge.
Contrast media:
IV:if indicated by the radiologist
Oral:No
Rectal: No
-Injection rate: 2.0 cc /sec
Scan delay time : 30 min
Scan type : axial slice thickness (2.5mm)
Viewing ( photography S.T ( 250-300ww ) ( 35-50wl), B.W (1500-2000ww ) ( 300-500 wl).
- Reconstruction:
Sag
Cor: yes
Axial:
3D display :
- Special instruction : raw data must be saved
- Remarks:
1-Call patient don't move.
2-in foreign body cases we must do coronal reconstruction and print B.W routinely.
3-Slices paralled to base line.
Post Nasal Space
Anatomic region: Neck
Positioning Supine, (I.O.M line ) parallel to x-ray beam,head first.
Scout view: AP and lateral length (300-35 0mm) angle 0 degree.
Scan area: post nasal space
Contrast media :if indicated by the radiologist
IV: 50 cc
Oral: No
Rectal: No
- Injection rate: 2.0 cc/sec
- Scan delay time : 30 sec
Scan type : Helical CT axial slice thickness 3.75mm .
Viewing ( photography) :S.T ( 400-500ww) (25-50wl)
Reconstruction : in indicated by the radiologist
Sag:
Cor:
Axial:
3D display :
Special instruction: raw data must be saved.
- Remarks:
1. call patient don't move.
2. move all metal thing from scan area.
3. Stop swallowing
Paranasal sinuses (coronal)
Anatomic region: sinuses.
Positioning : prone, (I.O.M line) vertical to x-ray beam,head first.
Scout view: lateral, length (150-250mm), no angle.
Scan area from anterior marginal orbits and ending toinclude sphinoidal sinus
Contrast media:No
IV:No
Oral : No
Rectal : No
Scan type : axial slice thickness ( 3.75mm )
Viewing (photography ): (1800-2000ww) (- 100- -200wl)
Reconstruction : if indicated by the radiologist
Sag:
Cor:Yes
Axial
3D display :yes
Special instruction raw data must be saved.
- Remarks:
1. call patient don't move.
2. remove all metal thing from scan area.
Para nasal sinuses ( axial )
Anatomic region: sinuses.
Positioning supine, (I.O.M line ) parallel to x-ray beam,head first
Scout view: AP and lateral, length ( 150-250mm ), Angle 0 degree.
Scan area from hard palate to top of frontal sinuses.
Contrast media :as indicated by the radiologist.
IV: 50 cc
Oral:No
Rectal:No
- Injection rate: 2.0cc/sec
Scan delay time 30sec
- Scan type: axial slice thickness ( 3.75 mm )
Viewing ( photography) ( 1800-2000ww ) ( -100 - -200 wl)
Reconstruction : if indicated.
Sag
Cor: yes
Axial:
3D display yes
Special instruction : raw data must be saved
Remarks:
1. call patient don't move.
2. remove all metal thing from scan area.
Nasopharynx
- Anatomic region : Neck
Positioning supine, neck slightly extended.
Scout view:
AP & lateral, length (200-250 mm) angle 0 degree.
Scan area: from base skull to hard palate.
Contrast media if indicated by the radiologist.
IV:50cc
Oral:No
Rectal:No
- Injection rate: 20cc/sec
Scan delay time : 35 sec
Scan type Helical slice thickness ( 3-5 mm)
Viewing (photography): S.T ( 400-500ww ) ( 25-50 wl)
- Reconstruction : if indicated by the radiologist
Sag:
Cor:
Axial:
3D display:
Special instruction : raw data must be saved.
- Remarks:
1. call patient don't move.
2. move all metal thing from scan area.
3. Suspend respiration.
Brain (Adult
Anatomic region: Brain
Positioning Supine, (IOM ) parallel to x-ray beam, head first.
Scout view: AP and lateral, length (150-250) mm, Angle 0 degree.
Scan area from foramen magnum to vertex.
Contrast media
IV: if indicated 50 e.c
Oral : No
Rectal No
Injection rate 20 c.c /sec
Scan delay time :(1-2 min)
Scan type axial, slice thickness ( 2.5 mm post fossa and 7.5 brain tissue)
Viewing ( photography) S.T ( 150-75 ww) - ( 35-50 wl), B.W (1300-2000 ww ) ( 300-500 wl)
- Reconstruction : if needed
Sag: yes
Cor : yes
Axial:
3D display : yes
Special instruction : Raw data must be saved.
- Remarks:
1- call patient don't move.
2- remove all metal thing from scan area
3-bone window is necessary in trauma cases R/O fracture in malignancy tumors R/O bone defect.
Brain (pediatric)
Anatomic region Brain
Positioning Supine, IOM parallel to x-ray beam, head first.
Scout view: lateral, length ( 150-250mm), angle 0 degree.
Scan area from foramen magnum to vertex.
Contrast media
IV: in indicated
Oral NO
Rectal: NO
Injection rate : manual injection
Scan delay time (1-2 min)
Scan type axial, slice thickness ( 2.5m posterior fossa and 5.0mm brain tissue)
Viewing(photography) ST (150-75 ww ) ( 35-50 ww) ( 300-500wl)
- Reconstruction : if needed
Sag:yes
Cor: yes
Axial:
3D display : yes
Special instruction : Raw data must be saved.
-Remarks:
1- Baby should be in deep sleeping.
2- Remove all metal thing from scan area.
J-Bone window is necessary in trauma cases R/O fractures and in malignancy tumors R/O bone defect.
4- If I.V contrast indicated are given the baby 1.0 ml every 1.0 k.g (1.0ml/1.0k.g)
Neck
- Anatomic region : Neck
- Positioning Supine, neck slightly extended, shoulder down,head first.
Scout view: AP and lateral, length (350-500mm), angle 0 degree.
Scan area : from base skull to the upper chest .
Contrast media :if indicated by radiologist.
IV:50 cc
Oral:No
Rectal:No
- Injection rate: 2 cc/sec
- Scan delay time : 35sec
Scan type : Helical, slice thickness 5.0 mm.
Viewing (photography ): ST. ( 400-500 ww) ( 25-50 ml)
- Reconstruction : if indicated by radiologist.
Sag:
Cor:
Axial:
3D display:
Special instruction : raw data must be saved.
- Remarks:
1. call patient don't move.
2. move all metal thing from scan area.
3. Stop swallowing.
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Mandible & 3D
- Anatomic region : Mandible
- Positioning supine, (I.O.M line) paral lel to x-ray beam,head first.
Scout view: AP and lateral, length ( 150-25 0mm), Angle 0degree.
- Scan area : hard palate to end of the chine
Contrast media :if indicated indicated by the radiologist
IV: 50 cc
Oral:No
Rectal:zno
Injection rate:2.0 cc/sec
Scan delay: time 1 minute
Scan type : Helical slice thickening ( 1-2 mm)
Viewing (photography. B.W (1500-2500ww) (300-500wl)
- Reconstruction : yes
Sag:yes
Cor:yes
Axial:yes
3D display yes
Special instruction : raw data must be saved
- Remarks:
1. call patient don't move.
2. move all metal thing from scan area.
3. soft tissue window if indicated.
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