Routine A/P
10/4/2017
No bladder delays unless ordered as a dedicated Renal Exam/Delays for cysts are no longer required 10/7/16
Helical 5mm x 5mm
Recon 2: 2.5mm x 2.5mm Standard Algorithm
Recon 3: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Recon 4: 2.5mm spacing x 2.5mm thickness Bone Algorithm
Sagittal and Coronal 2mm x 2mm Reformats from Recon 3.
Send Recon 2 and Sag/Cor Reformats to PACS.
Abdomen for Adrenal Mass
11/11/2021
Helical 5mm x 5mm w/o contrast
60-75 sec delay (per Dr. Gray) Helical 2.5mm x 2.5mm with contrast
Recon 2: 0.625mm spacing x 1.25mm thickness Standard Algorithm
15 min delay Helical 2.5mm x 2.5mm
Recon 2: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Recon 3: 2.5mm x 2.5mm Bone Algorithm
Sag/Cor 2mm x 2mm reformats from both recon 2’s.
Send all but Recon 2’s to PACS
Abdomen for Renal Stone
10/4/2017
Helical 2.5mm x 2.5mm Standard Algorithm
Recon 2: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Recon 3: 2.5mm spacing x 2.5mm thickness Bone Algorithm
Sag/Cor 2mm x 2mm reformats from Recon 2
Send initial acquisition, Recon 3 and Sag/Cor to PACS
Abdomen Pelvis for Hematuria
8/31/2017
If there is a diagnosis or question of hematuria, do w/o, 70 sec delay, and a 5 min. delayed kidneys thru bladder. If there is push back from the ordering physician, consult with the radiologist.
Multiphase Abdomen (Liver Mass/Renal Mass)
8/8/2018
Anytime Dr. Goodman orders a W/WO of the liver, he wants Multiphase Liver
Helical 5mm x 5mm w/o contrast
Injection 4cc per second
30 sec delay Helical 2.5mm x 2.5mm with contrast (Omni 350)
Recon 2: 0.625mm spacing x 1.25mm thickness Standard Algorithm
70 sec delay Helical 2.5mm x 2.5mm
Recon 2: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Recon 3: 2.5mm x 2.5mm Bone Algorithm
3 min delay Helical 2.5mm x 2.5mm
Sag/Cor 2mm x 2mm reformats from both recon 2’s
Send all but Recon 2’s to PACS
Multiphase Abdomen (Pancreatic Mass)
1/30/2018
Same as Liver but reformat 1.25 x 1.25mm slices through area of Pancreas.
Multiphase Abdomen for Hemangioma
2/3/2017
As above, then:
If area of interest is not filled;
6 min delay Helical 2.5mm x 2.5mm
Sag/Cor on both recon 2’s
Send all but Recon 2’s to PACS
CTE(CT Enterography)
1/17/2020
CT Enteroclysis requires a tube placed, and we do not do those. However, many offices mistake one for the other.
If 14 years old or younger, treat as peds case and consult Dr. Verville
Pt to Arrive 1 hr prior to exam
1 Btl Volumen every 20 min
One Reglan Tab with First Btl
Glucagon Injection just prior to starting scan
100 cc Omni 350 @ 4cc per sec
45 Second Delay
Helical 1.25mm x 1.25mm
MIPS 3mm thick x 1.25 spacing
Sag and Cor 2mm x 2mm Reformats in Standard Algorithm
Send all to PACS
Note in PACS: “CTE. 10MG REGLAN GIVEN PO, 1350ML VOLUMEN GIVEN P.O., 1ML GLUCAGON GIVEN I.M.”ß(or IV if applicable)
CT Urogram
10/04/2017
Helical Abd/Pel 2.5mm x 2.5mm w/o contrast
145ml of Omni 350 Total
Inject 30ml at 2.0ml per second then wait 7 minutes
Inject 50ml at 1.5ml per second then wait 20 seconds
Inject 65ml at 3.0ml per second then watch the time and start scan at the 8.5 minute mark
Start the scan 8.5 minutes after the first injection starts. You cannot put in a delay that long on the scanner, so you just have to watch the time on the injector. Make sure to start the scan promptly at 8.5 minutes(510 seconds).
Helical 2.5mm x 2.5mm Standard Algorithm
Recon 2: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Recon 3: 2.5mm spacing x 2.5mm thickness Bone Algorithm
Sag/Cor 2mm x 2mm Reformats from recon 2
Send all but Recon 2 to PACS
CT CYSTOGRAM
INSTRUCTIONS:
Scan Pelvis
RN inserts catheter
Scan bladder
Introduce at least 300ml(until pt is uncomfortable) of NON-diluted Omni 300 by gravity. Clamp foley catheter.
Scan bladder.
Ask rad to review the images for adequate contrast
If contrast is adequate, patient to void bladder
Post void scan of bladder
Follow scanning protocol below for all image acquisition
SCOUT:
POSITION: SUPINE
ORIENTATION: FEET FIRST
PLANE: 0 DEGREES & 90 DEGREES
ACQUISITION SERIES:
SCAN TYPE: HELICAL
ROTATION TIME: 0.8 SECONDS
THICKNESS: 2.5mm
INTERVAL: 2.5mm
KV: 120
MA: AUTO MA
SFOV: LARGE BODY
DFOV: UP TO 50
RECON TYPE: STD
PROSPECTIVE 2:
THICKNESS: 1.25
INTERVAL: 1.25
REFORMAT SAGITAL & CORONAL IMAGES FROM PROSPECTIVE 2
CT Colonography
07/08/2020
Cannot be scanned Downtown
Must be scheduled on a day when Drs. Gray, Kyle, or Johnston are at that facility.
Prep Instructions:
Please read the instructions for the Bowel Prep Kit along with the following instructions before beginning. The day before the CT Colonography, you will start this prep and begin the Bowel Prep Kit according to the directions in the package. The two preps will be taken in conjunction. For breakfast the day before the exam, drink one bottle of Tagitol with a liquid breakfast. For lunch the day before the exam, drink the second bottle of Tagitol with a liquid lunch. For dinner the day before the exam, drink the third bottle of Tagitol with a liquid dinner. Please do not eat, drink, or take any medications the morning of your procedure. Please expect to be here for approximately one hour. If you have any questions please call 423-553-1234.
Dress patient in gown and shoes, no underwear.
You will need 2-3 packs of warm lubrication on 4×4 gauze, enema kit, balloon inflation device and pump.
Tape “exam in progress” sign on both CT doors and keep both closed. Have red bag ready.
Exam:
Scout patient before inserting tip and show radiologist to determine if patient is cleaned out enough.
Insert tip in Sims position, lay patient supine, perform AP scout to verify balloon is inflated. Call radiologist.
Radiologist will fill colon with air.
Scout(single scout) again to verify there is enough air
Scan from flexures through rectum. Helical 5mm x 5mm Standard Algorithm
Recon 2: 2.5mm x 2.5mm Standard Algorithm
Recon 3: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Recon 4: 2.5mm x 2.5mm Bone Algorithm
Place patient in the prone position and scout to verify adequate air.
Scan from flexures through rectum. Helical 5mm x 5mm
Recon 2: 2.5mm x 2.5mm Standard Algorithm
Recon 3: 0.625mm spacing x 1.25mm thickness Standard Algorithm
Send Recon 2 and 3 and 4 to PACS.
Remove tip and put kit in red bag.
Bony Pelvis
2/3/2017
Helical 2.5mm x 2.5mm Std. Algorithm
Recon 2: 0.625mm spacing x 1.25mm thickness Bone Algorithm
Recon 3: 2.5mm x 2.5mm Bone Algorithm
Sag/Cor 2mm x 2mm Reformats from Recon 2
Send initial acquisition, Recon 2, Recon 3 and Sag/Cor 2×2 Bone and Std Reformats to PACS