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
3.CT- 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+

4.CT- 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

5.CT- 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

6.CT- 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

7.CT- 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
8.CT- 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

C.spine – centered hyoidbone
D.spine – 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  : C.spine – From base of skull to D1

D.spine – 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

9.CT- 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

10.CT- 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

11.CT- 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
12.CT- 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

13.CT- 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

14.CT- 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
15.CT-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
16.CT-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
17.CT- 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
18.CT- 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

19.CT- 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

20.CT- 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

21.CT- 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
22.CT- 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