CT – PROTOCOLS
1. CT – BRAIN
Indications:
Headache, vomiting, vertigo, LOC, weakness of limbs, ?tumor, ?aneurysm, ?
malformation
Patient preparation:
Remove metal objects from the region of interest (Head)
Anatomical reference: Orbito Meatal line
Patient orientation: Head first
Patient position: Supine
Centered at outer canthus of eye
Topogram : lateral
Scan type – scout
Kv – 120
mA – 20
scout plane – 90
Planning: Base of skull to skull vault
Scan type: Axial
Rotation time – 2 sec
Base of skull Brain parenchyma
Axial thickness 5mm 7.5mm
Retro 1.25mm 2.5mm
No of images per 1i 2i
rotation
Interval 5mm 15mm
Gantry tilt parallel to OM line
S fov head head
Kv 140 120
mA 180 160
Recon type soft soft
Contrast study:
No preparation required
21G scalp vein set used
25ml of contrast given through hand injection
Children (depending on patient weight) 1.5ml/kg
In case of tumor/ malformation contrast study should be done in 5mm axial
thickness
Filming:
Plain study
Head window of axial images in 20 format – 1 film
Contrast study
Head window of axial images in 20 format – 1 film
If needed coronal and sagittal reformations in head window
Bone window should be given for trauma / bone pathology
Window settings:
Head window Bone window
WW - 80 to 100 WW – 2500 to 3000
WL - 40 to 50 WL – 300 to 500
2. CT – PNS
Indications:
Recurrent nasal block, headache, chronic sinusitis
Patient preparation:
Remove metal objects from the region of interest
Anatomical reference: Orbito Meatal line
Patient orientation: Head first
Patient position: prone
Centered at outer canthus of eye
Topogram : AP/lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 20
scout plane 0 90
Planning: From dorsum sellar to anterior margin of frontal sinus
Scan type: Axial
Rotation time –2 sec
Axial thickness 5mm
Retro 1.25mm
No of images per 1i
rotation
Interval 5mm
Gantry tilt perpendicular to OM line
SFov head
Kv 140
mA 180
Recon type bone
Filming:
- Bone window of axial images in 20 format
- last four cuts sagittal reformations
Window settings:
Bone window
WW – 2500 to 3000
WL –300 to 500
[Link]- THORAX
Indications:
Suspicion of pathology in X ray – chest, ?PTB ,? Mass , to look for thymus , to look for
oesophagus
Patient preparation:
Remove metal objects from chest region
Patient changed to hospital gown
Breathing instructions should be given
Anatomical reference: Sternal Notch
Patient Orientation : Feet First
Patient Position : Supine
Centered at sternal notch
Topogram: AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : Apex to Base of Lung
Scan Type : Helical
Rotation length - full
Rotation time -0.7 sec
Thick speed
Helical Thickness - 7.5mm
Retro 2.5mm
Scan Mode - 1.675:1
Speed(mm/rot) - 33.50
Interval - 7.5mm
Gantry Tilt : 0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
Perform HRCT if required – ? ILD
HRCT – Thorax
Scan type : axial
Rotation time : 0.8
Axial thickness : 1.25mm
No of images per rotation : 1i
Interval : 10mm
Sfov : large
Kv : 120
mA : 300
Recon type : bone
Contrast study:
RFT should be normal serum creatinine - 1.5mg/dl
BUN - 40mg/dl
20/18 G venflon is used
Amount of contrast – 40ml of Iohexol + 20 ml of normal saline
Children (depending on patient weight) 1.5ml/kg
Flow rate – 2.9ml/sec
Pressure limit – 100 psi
Arterial phase:
Helical thickness : 5mm (Retro 1.25mm)
Scan Mode : 1.675:1
Speed(mm/rot) : 16.75
Interval : 5mm
Prep group delay : 20 sec
Venous phase:
Helical thickness : 5mm (Retro 1.25mm)
scan Mode : 1.675:1
Speed(mm/rot) : 16.75
Interval : 5mm
Prep group delay : 45 sec
Filming:
Plain study
Mediastinal window of axial images – 1 or 1½ film in 20 format
Lung window of axial images - 1 or 1½ film in 20 format
Coronal reformation – ½ film
HRCT lung window of axial images – 1 film 20/16 format
Contrast study
Mediastinal window of axial images in arterial phase - 1½ or 2 films in 20 format
Coronal and Sagittal reformation in arterial phase – 1 film in 20/16 format
Depending on the pathology lung / mediastinal window should be given for
reformations
If any bone pathology noted bone window should be given
If needed venous phase should be filmed
Window settings:
Mediastinal window Lung window
WW – 350 to 500 WW – 1500 to 1700
WL – 30 to 50 WL – -600 to -700+
[Link]- WHOLE ABDOMEN
Indications:
Abdominal pain, vomiting, diahorrea, ?mass, ?bowel obstruction , ?ATB, follow up of
carcinoma.
Patient preparation:
Nil per oral for 6 hrs prior to examination
Oral contrast – 1 liters water or buttermilk given 1 hour prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Table dose of 200ml water should be given
Breathing instructions should be given
Anatomical reference: Xiphysternum
Patient Orientation : Feet First
Patient Position : Supine
Centered at Xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : Dome of diaphragm to Pubic symphysis
Scan Type : Helical
Rotation length - full
Rotation time -0.8 sec
Thick speed
Helical Thickness - 7.5mm
Retro - 2.5mm
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
Contrast study:
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 405mg/dl
20/18 G venflon is used
Amount of contrast – 50ml of Iohexol + 20 ml of normal saline
Flow rate – 2.9ml/sec
Pressure limit – 100 psi
Arterial phase:
Planning : dome of diaphragam to iliac crest
Helical thickness : 7.5mm (Retro2.5mm)
Scan Mode : 1.35:1
Speed(mm/rot) : 27.00
Interval : 7.5mm
Prep group delay : 18 to 20 sec
Venous phase:
Planning as whole abdomen
Helical thickness : 5mm (Retro 1.25mm)
scan Mode : 1.35:1
Speed(mm/rot) : 27.00
Interval : 5mm
Prep group delay : 45 - 50 sec
Filming:
Plain study
Abdomen window of axial images – 1½ to 2 film in 20 format
Abdomen window of Coronal reformation –1 or ½ film
Contrast study
Abdomen window of axial images in venous phase - 2 or 2½
films in 20 formats
Abdomen window of Coronal and Sagittal reformation in venous
phase – 1 film in 20/16 format
If any bone pathology noted bone window should be given
Filming should be done in arterial phase if needed
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- UPPER ABDOMEN
Indications:
Pancreatitis, hemangioma-liver, epigastric pain, GB pathology
Patient preparation:
Nil per oral for 6 hrs prior to examination
Oral contrast – 1 litre water or buttermilk given 1 hour prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Table dose of 200ml water should be given
Breathing instructions should be given
Anatomical reference: Xiphysternum
Patient Orientation : Feet First
Patient Position : Supine
Centered at Xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : Dome of diaphragm to iliac crest
Scan Type : Helical
Rotation length - full
Rotation time -0.8 sec
Thick speed
Helical Thickness - 7.5mm (Retro2.5mm)\
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
Contrast study:
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40
20/18 G venflon is used
Amount of contrast – 40ml of Iohexol + 20 ml of normal saline
Children (depending on patient weight) 1.5ml/kg
Flow rate – 2.9ml/sec
Pressure limit – 100 psi
Arterial phase:
Planning as like plain study
Helical thickness : 5mm (Retro 1.25mm)
Scan Mode : 1.35:1
Speed(mm/rot) : 16.75
Interval : 5mm
Prep group delay : 18 to 22 sec
Venous phase:
Planning as like plain study
Helical thickness : 5mm (Retro 1.25mm)
Scan Mode : 1.35:1
Speed(mm/rot) : 16.75
Interval : 5mm
Prep group delay : 45 to 50 sec
Filming:
Plain study
Abdomen window of axial images – 1 or 2 film in 20 format
Abdomen window of Coronal reformation –1 film
Contrast study
Abdomen window of axial images in venous phase - 2 films in
20 format
Abdomen window of Coronal and Sagittal reformation in venous phase – 1 film
in 20/16 format
If any bone pathology noted bone window should be given
Filming should be done in arterial phase if needed
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- LOWER ABDOMEN
Indications:
Pelvic mass, renal mass, RIF mass/appendicitis
Patient preparation:
Nil per oral for 6 hrs prior to examination
Oral contrast – 1 litre water or buttermilk given 1 hour prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Bladder should be full if needed
Breathing instructions should be given
Anatomical reference: Xiphysternum
Patient Orientation : Feet First
Patient Position : Supine
Centered at Xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : D12 to pubic symphysis
Scan Type : Helical
Rotation length - full
Rotation time - 0.8 sec
Thick speed
Helical Thickness - 7.5mm
Retro - 2.5mm
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
Contrast study:
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40
20/18 G venflon is used
Amount of contrast – 40ml of Iohexol + 20 ml of normal saline
Children (depending on patient weight) 1.5ml/kg
Flow rate – 2.9ml/sec
Pressure limit – 100 psi
Arterial phase:
Planning as like plain study
Helical thickness : 5mm (Retro 1.25mm)
Scan Mode : 1.35:1
Speed(mm/rot) : 16.75
Interval : 5mm
Prep group delay : 18 to 22 sec
Venous phase:
Planning as like plain study
Helical thickness : 5mm (Retro 1.25mm)
Scan Mode : 1.35:1
Speed(mm/rot) : 16.75
Interval : 5mm
Prep group delay : 45 to 50 sec
If needed delayed phase taken
Filming:
Plain study
Abdomen window of axial images – 1 or 2 film in 20 format
Abdomen window of Coronal reformation –1 film
Contrast study
Abdomen window of axial images in venous phase - 2 films in 20 format
Abdomen window of Coronal and Sagittal reformation in venous phase – 1 film
in 20/16 format
If any bone pathology noted bone window should be given
Filming should be done in arterial phase if needed
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- KUB
Indications:
Renal caluli , ureteric calculi, ectopic kidney, bladder mass, pyelonephritis
Patient preparation:
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Bladder should be full
Anatomical reference: Xiphysternum
Patient Orientation : Feet First
Patient Position : Supine
Centered at Xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : D11 to pubic symphysis
Scan Type : Helical
Rotation length - full
Rotation time -0.8 sec
Thick speed
Helical Thickness - 7.5mm
Retro - 2.5mm
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : 0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
Filming:
Abdomen window of axial images – 1½ film in 20 format
Abdomen window of Coronal reformation –½ film
If any bone pathology noted bone window should be given
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- SPINE
Indications:
Fracture, osteomelitis, dislocation
Patient preparation:
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Patient Orientation : Feet First
Patient Position : Supine
[Link] – centered hyoidbone
[Link] – centered at sternal notch
L.S spine – centered at xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : [Link] – From base of skull to D1
[Link] – From C7 to L1
L.S spine – From D12 to pubic symphysis
Scan Type : Helical
Rotation length - full
Rotation time - 0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : 0.0
sFov : large
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window of axial images – 2 film in 16 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with thick mips – 1 film in 6 format
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- SHOULDER JOINT
Indications:
?Fracture, dislocation
Patient preparation:
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Patient Orientation : Head First
Patient Position : Supine
Centered at sternal notch
Halfcentered to side of interest
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From acromio clavicular joint to proximal
part of humerus
Scan Type : Helical
Rotation length - full
Rotation time - 0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : small
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window of axial images – 1 or 2 film in 16 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with thick mips – 1 film in 6 format
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- KNEE JOINT
Indications:
?Fracture, dislocation, ?mass
Patient preparation:
Metal objects should be removed from the region of interest
Patient Orientation : Feet First
Patient Position : Supine
Centered at patella
Halfcentered to side of interest
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From distal part of femur to proximal part of tibia
Scan Type : Helical
Rotation length - full
Rotation time - 0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : small
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window of axial images – 2 film in 16 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with thick mips – 1 film in 6 format
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- ANKLE JOINT
Indications:
?Fracture, dislocation,
Patient preparation:
Metal objects should be removed from the region of interest
Patient Orientation : Feet First
Patient Position : Supine
Centered at ankle joint
Halfcentered to side of interest
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From distal part of tibia to calcaneum
Scan Type : Helical
Rotation length - full
Rotation time -0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : small
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window of axial images – 2 film in 16 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with thick mips – 1 film in 6 format
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- ELBOW JOINT
Indications:
?Fracture, dislocation,
Patient preparation:
Metal objects should be removed from the region of interest
Patient Orientation : Feet First
Patient Position : Supine
Hand kept above the head
Centered at elbow joint
Halfcentered to side of interest
If this is not possible put the patient in head first and keep the elbow by the side of the
body and half center it
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From distal part of humerus to proximal
part to radius and ulna
Scan Type : Helical
Rotation length - full
Rotation time -0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : small
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window of axial images – 2 film in 16 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with thick mips – 1 film in 6 format
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- PELVIS
Indications:
?Fracture, dislocation,
Patient preparation:
Patient changed to hospital gown
Metal objects should be removed from the region of interest
Patient Orientation : Feet First
Patient Position : Supine
Centered at Iliaccrest
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From L5 to proximal part of femur
Scan Type : Helical
Rotation length - full
Rotation time - 0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window of axial images – 2 film in 16 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with thick mips – 1 film in 6 format
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- FACE
Indications:
Facial deformity, facial bones fracture, cleft palate - lip
Patient preparation:
Metal objects should be removed from the region of interest
Anatomical reference: Orbito Meatal line
Patient Orientation : Head first
Patient Position : Supine
Centered at outer canthus of eye
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From skull vault to C1
For maxilla or mandible cover from orbit to mandible
Scan Type : Helical
Rotation length - full
Rotation time - 0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : head
kv : 120
mA : 200
Recon Type : bone plus
Filming:
Bone window and soft tissue window of axial images – 3 films
in 20 format
Bone window of Coronal and sagittal reformation –1film in 16
format
3D reconstruction with surface rendering– 1 film in 9 format
If needed head window of axial images should be given
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
Soft tissue window
WW – 350 to 500
WL – 30 to 50
[Link]-NECK
Indications:
?mass/growth , abscess, tracheal narrowing
Patient preparation:
Metal objects should be removed from the region of interest
Anatomical reference: Orbito Meatal line
Patient Orientation : Head first
Patient Position : Supine
Centered at hyoid bone
Chin raised
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : From base of skull to carina
Scan Type : Helical
Rotation length - full
Rotation time -0.8 sec
Thick speed
Helical Thickness - 5mm
Retro - 1. 25mm in std recon
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Gantry Tilt : s0.0
sFov : small
kv : 120
mA : 280
Recon Type : standard
Contrast study:
RFT should be normal serum creatinine - 1.5mg/dl
BUN - 40
20/18 G venflon is used
Amount of contrast – 40ml of Iohexol + 20 ml of normal saline
Children (depending on patient weight) 1.5ml/kg
Flow rate – 2.9ml/sec
Pressure limit – 100 psi
Arterial phase
Planning as like plain study
Helical Thickness - 5mm
Retro -1. 25mm
Scan Mode -0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Venous phase
Planning as like plain study
Helical Thickness - 5mm
Retro - 1. 25mm
Scan Mode - 0.875:1
Speed(mm/rot) - 8.75
Interval - 5mm
Prep group delay : 35 sec
Filming:
Plain study
Soft tissue window of axial images – 1½ to 2 films in 20 format
Soft tissue window of Coronal and sagittal reformation –1film in
16 format
Contrast study
Soft tissue window of axial images in venous phase – 2 films in
20 format
Soft tissue window of Coronal and sagittal reformation in venous phase –1film
in 16 format
Filming should be done in arterial phase if needed
Window settings:
Soft tissue window
WW – 350 to 500
WL – 30 to 50
[Link]-TEMPORAL BONE
Indications:
Facial palsy, fracture of temporal bone, to evaluate cochlea
Patient preparation:
Metal objects should be removed from the region of interest
Anatomical reference: Orbito Meatal line
Patient Orientation : Head first
Patient Position : Supine
Centered at outer canthus of eye
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning :
Scan Type : Axial
Rotation time - 2.0 sec
Thick speed
Axial Thickness - 1. 25mm
No of images per
rotation - 4i
Gantry Tilt : s0.0
SFov : small
kv : 120
mA : 280
Recon Type : bone plus
Patient position: prone
Centered at outer canthus of eye
Topogram : AP/lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 20
scout plane 0 90
Planning:
Scan Type : Axial
Rotation time - 2.0 sec
Thick speed
Axial Thickness - 1. 25mm
No of images per
rotation - 4i
Gantry Tilt : s0.0
SFov : small
kv : 120
mA : 280
Recon Type : bone plus
Filming:
Bone window of axial images – 1 film in 20 format
Bone window of Coronal images –1film in 20 format
Sagittal reformations with thick mips – 1 film
3D reconstruction if needed – 1 film
Window settings:
Bone window
WW – 2500 to 3000
WL – 300 to 500
[Link]- RENAL ANGIOGRAM
Indications:
Renal donar, Renal hypertension
Patient preparation:
Nil per oral for 6 hrs prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40mg/dl
18 G venflon is used
Breathing instructions given to the patient
Anatomical reference: Xiphysternum
Patient Orientation : Feet First
Patient Position : Supine
Centered at Xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : D11 to Pubic symphysis
Scan Type : Helical
Rotation length - full
Rotation time -0.7 sec
Thick speed
Helical Thickness - 7.5mm (Retro 2.5mm)
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
SMART PREP:
Monitor Phase : Abdominal aorta one cut above upper pole of
kidney
mA : 60
Monitoriong delay
Monitoring ISD : 8.0 sec
Diagnostic delay : 5.0
Contrast study:
Amount of contrast – 80ml of Iohexol + 20 ml of normal saline
Flow rate – 3.3ml/sec
Pressure limit – 100 psi
Arterial phase
Planning : D11 to Pubic symphysis
Rotation time : 0.6 sec
Helical thickness : 3.75mm
Retro : 1.25mm
Scan Mode : 1.35:1
Speed(mm/rot) : 13.50
Interval :3.75mm
Venous phase:
Planning : D11 to Pubic symphysis
Rotation time : 0.7 sec
Helical thickness : 7.5mm
Retro : 2.5mm
Scan Mode : 1.35:1
Speed(mm/rot) : 27.00
Interval : 7.5mm
Prep group delay : 10sec
If needed delayed scout / phase will be taken
Filming:
Axial images of plain study in abdomen window – 1 film in 20 format
Axial images of contrast study in abdomen window 2 films in 20 format
Thick mips – 1 film in 6 format
3D reconstruction -1film in 6 format
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- PULMONARY ANGIOGRAM
Indications:
Pulmonary hypertension, to rule out pulmonary embolism
Patient preparation:
Nil per oral for 6 hrs prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40mg/dl
18 G venflon is used
Breathing instructions given to the patient
Anatomical reference: sternal notch
Patient Orientation : Feet First
Patient Position : Supine
Centered at sternal notch
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : apex to base of lungs
Scan Type : Helical
Rotation length - full
Rotation time -0.7 sec
Thick speed
Helical Thickness - 7.5mm (Retro 2.5mm)
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
SMART PREP:
Monitor Phase : Main pulmonary artery
mA : 60
Monitoriong delay
Monitoring ISD : 8.0 sec
Diagnostic delay : 5.0
Contrast study:
Amount of contrast – 80ml of Iohexol + 20 ml of normal saline
Flow rate – 3.3ml/sec
Pressure limit – 100 psi
Arterial phase
Planning : base of lungs to apex
Rotation time : 0.6 sec
Helical thickness : 3.75mm
Retro : 1.25mm
Scan Mode : 1.35:1
Speed(mm/rot) : 13.50
Interval : 3.75mm
Filming:
Axial images of plain study in mediastinal window – 1 film in 20 format
Axial images of contrast study in mediastinal window - 1½films in 20 format
Axial images of contrast study in lung window - 1½films in 20 format
Thick MIPS – 1 film in 6/9 format
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- AORTIC ANGIOGRAM
Indications:
Aorticdissection , aorticstenosis, aortoarthritis, aorticaneurysm
Patient preparation:
Nil per oral for 6 hrs prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40mg/dl
18 G venflon is used (right hand)
Breathing instructions given to the patient
Anatomical reference: Sternal Notch
Patient Orientation : Feet First
Patient Position : Supine
Centered at Sternal Notch
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : sternal notch to head of femur
Scan Type : Helical
Rotation length - full
Rotation time - 0.7 sec
Thick speed
Helical Thickness - 7.5mm (Retro 2.5mm)
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
SMART PREP:
Monitor Phase : Decending aorta at thoracic level
mA : 60
Monitoriong delay
Monitoring ISD : 8.0 sec
Diagnostic delay : 5.0
Contrast study:
Amount of contrast – 100ml of Iohexol + 20 ml of normal saline
Flow rate – 3.3ml/sec
Pressure limit – 100 psi
Arterial phase
Planning : sternal notch to head of femur
Rotation time : 0.6 sec
Helical thickness : 5.00mm
Retro : 1.25mm
Scan Mode : 1.675:1
Speed(mm/rot) : 16.75
Interval : 5.00mm
Filming:
Axial images of contrast study in abdomen window -3 films in 20 format
Thick mips – 1 film
3D reconstruction -1film
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- PERIPHERAL ANGIOGRAM
Indications:
Claudication , gangrene , non palpable distal pulse
Patient preparation:
Nil per oral for 6 hrs prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interest
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40mg/dl
18 G venflon is used
Breathing instructions given to the patient
Anatomical reference: Xiphysternum
Patient Orientation : Feet First
Patient Position : Supine
Centered at Xiphysternum
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : For LL Angio - D11 to foot
For UL Angio – covering the whole hand including arch
Plain scan only for smart prep
Scan Type : Helical
Rotation length - full
Rotation time - 0.7 sec
Thick speed
Helical Thickness - 7.5mm (Retro 2.5mm)
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : large
kv : 120
mA : 280
Recon Type : standard
SMART PREP:
Monitor Phase (LL): Abdominal aorta one cut above upper pole of
Kidney
Monitor Phase (UL): common carotid artery
mA : 60
Monitoriong delay
Monitoring ISD : 8.0 sec
Diagnostic delay : 5.0
Contrast study:
Amount of contrast – 100ml of Iohexol + 20 ml of normal saline
Flow rate – 3.3ml/sec
Pressure limit – 100 psi
Arterial phase
Planning : D11 to foot
Rotation time : 0.6 sec
Helical thickness : 5.00mm
Retro : 1.25mm
Scan Mode : 1.675:1
Speed(mm/rot) : 16.75
Interval : 5.00mm
Filming:
Axial images of contrast study in abdomen window -3 films in 20 format
Thick mips – 1 film
3D reconstruction -1film
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- CAROTID ANGIOGRAM
Indications:
?carotid aneurysm/stenosis, ascending aortic aneurysm
Patient preparation:
Nil per oral for 6 hrs prior to examination
Patient changed to hospital gown
Metal objects should be removed from the region of interes
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40mg/dl
18 G venflon is used
Breathing instructions given to the patient
Anatomical reference: sternal notch
Patient Orientation : head first
Patient Position : Supine
Centered at hyoid bone
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : base of skull to carina
Scan Type : Helical
Rotation length - full
Rotation time -0.7 sec
Thick speed
Helical Thickness - 7.5mm (Retro 2.5mm)
Scan Mode - 1.35:1
Speed(mm/rot) - 27.00
Interval - 7.5mm
Gantry Tilt : s0.0
sFov : small
kv : 120
mA : 280
Recon Type : standard
SMART PREP:
Monitor Phase : ascending aorta
mA : 60
Monitoriong delay
Monitoring ISD : 8.0 sec
Diagnostic delay : 5.0
Contrast study:
Amount of contrast – 80ml of Iohexol + 20 ml of normal saline
Flow rate – 3.2ml/sec
Pressure limit – 100 psi
Arterial phase
Planning : carina to base of skull
Rotation time : 0.6 sec
Helical thickness : 3.75mm
Retro : 1.25mm
Scan Mode : 1.35:1
Speed(mm/rot) : 13.50
Interval : 3.75mm
Filming:
Axial images of plain study in soft tissue window – 1 film in 20 format
Axial images of contrast study in soft tissue window -2 films in 20 format
Thick mips – 1 film in 6/9 format
3D reconstruction – 1 film
Window settings:
Abdomen window
WW – 350 to 500
WL – 30 to 50
[Link]- CORONARY ANGIOGRAM
Indications:
Atypical chest pain, abnormal ECG, positive TMT, Post stenting, Post CABG.
Patient preparation:
Heart rate, should be checeked if it is greater than 60 Betaloc should be given.
If it is asthmatic patient get cardiology opinion.
Nil per oral for 6 hrs prior to examination , no caffaine items
Patient changed to hospital gown
Metal objects should be removed from the region of interest
RFT should be normal serum creatinine- 1.5mg/dl
BUN - 40mg/dl
18 G venflon is used (Rt hand cubital vien)
Breathing instructions given to the patient
Anatomical reference: sternal notch
Patient Orientation : Feet first
Patient Position : Supine
Centered at sternal notch
Topogram : AP/ Lateral
AP Lateral
Scan type scout scout
Kv 120 120
mA 20 30
scout plane 0 90
Planning : 2”I above carina to apex
Calcium Scoring
Scan type :cine
Rotation time :0.35
Rotation length :segment
Thickness :2.5/16i
Angiogram
Scan type :cine
Cardiac mode :snapshot segment (Helical)
Detector coverage :40mm
Rotation time :0.35s
Rotation length :segment
Thickness :0.625mm
sFov : cardiac small
kv : 120
mA : auto mA
Recon Type : standard
Contrast
Amount of contrast – Patient wt x 1.2 ml + 30ml
Flow rate – 5.5ml/sec
Pressure limit – 100 psi
SMART PREP:
Monitor Phase : descending aorta
mA : 60
Monitoriong delay :10sec
Monitoring ISD : 1 sec
Diagnostic delay : 5.0
Filming:
Volume rendered images –2 film
Curved reformations – 1 film
Window settings:
Mediastinal window
WW – 350 to 500
WL – 30 to 50
