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CHEST CT SCAN PRESENTATION FOR NEW RADIOGRAPHERS AND CT SCAN TECHNICIANS .pptx
- 1. Chest CT scan Prepared By: RAHMATULLAH SULAIMAN KHAIL
- 2. Indication ? Chest Pain. ? Chest Trauma. ? Infection . ? Intra- thoracic Bleeding. ? Pulmonary embolism. ? Pneumonia . ? Suspected Tumor or mass. ? Assessment of interstitial lung disease. ? Minor fibrosis. ? Pregnancy . ? Hypersensitivity to iodinated contrast media (if contrast is used ). ? Renal failure. ? Heart disorder . Contra Indication
- 3. CT: Single stop Shop Chest ? Lungs ? Heart and great vessels ? Coronary arteries ? Chest wall and bones ? Tracheobronchial tree ? Esophagus ? Mediastinum ? Diaphragm Windows and reconstructions ? MIP (Maximum intensity Projection ? MinIP (minimum intensity projection ? VRT (Volume Rendering Technique ? MPR (Multi planar reformation) ? Soft tissue window ? Lung window ? Bone window
- 5. ? CEST for Routine ? HRCT ? Calcium scoring ? Thoracic CT angiography ? Pulmonary CT angiography ? Coronary CT angiography Overview of Chest CT-protocols
- 6. Routine CECT of chest Indications for: Contrast enhanced chest computed tomography Parameters/instructions Breathing Breath hold in inspiration Dari/ Pashto / English Slice thickness 1.5-3mm Contrast: IV contrast 1.5ml/ kg Performed by injector Oral Contrast no Flow rate 3 - 4.5 ml/sec 300 – 325 psi Scan phases: Pre contrast Yes thyroid to upper pole of kidney Late Arterial phase 30 -40 sec contrast should seen in Thoracic aorta – thyroid to upper pole of kidney Portal phase No need thyroid to upper pole of kidney Delayed Phase 3-5 min pericardial effusion bone and chest wall patalogies ) thyroid to upper pole of kidney
- 7. HRCT protocol Purpose axial viewing / documentation 2D/3D processing Window Slice Width 1.5 mm 1mm Lung & Soft tissue Increment 1mm 1mm Kernel 50-90 sharp 50-90 sharp ? Position the patient supine, prone, right or left lateral Head or feet first (suggested position supine – head first) ? Center the laser beam topogram over thyroid region ? Performed topogram – ? Performed high resolution Plain exam : from thyroid region up to upper pole of left kidney.
- 8. Chest CTA ? Aorta and branches ? Pulmonary arteries ? Coronary arteries
- 9. CT protocols For chest angiography Indications for: Contrast enhanced chest CT angiography Parameters/instructions Breathing Breath hold in inspiration Slice thickness 0.7-1.5mm Contrast: IV contrast 1.5ml/ kg Performed by enjector Oral Contrast no Flow rate 4.5 – 6 ml/sec 300 – 325 psi Scan phases: Pre contrast Yes thyroid to upper pole of kidney Early Arterial phase 20 -30 sec contrast (use bolus tracking soft ware) thyroid to upper pole of kidney
- 10. Bolus tracking soft ware ? The early arterial phase performed approximately 20-30 sec after contrast injection is initiated and is most accurately determine by using bolus tracking software (eg small prep) to monitor the level of contrast enhancement in the aorta and automatically triggering the scan when it reaches a pre determined level of enhancement (eg 120 HU)
- 11. Flow rate
- 12. CT protocols For Coronary CTA Indications for: For coronary pathologies ( plaque, thrombosis, calcifications and congenital anomolies) Parameters/instructions Breathing Breath hold in inspiration Slice thickness 0.7-1.5mm Contrast: IV contrast 1.5ml/ kg Performed by injector Oral Contrast no Flow rate 4.5 – 6 ml/sec 300 – 325 psi Scan phases: Pre contrast Are performed for calcium scoring rate Arcus aorta to left hemi diaphragmatic angle Early Arterial phase 20 -30 sec contrast (use bolus tracking software) Arcus aorta to left hemi diaphragmatic angle Note Coronary CTA performed BY ECG gated technique
- 13. CT protocols Calcium scoring Indications for: For coronary arteries for determine of blocked and narrowed by plaque calcification indicator for atherosclerosis Parameters/instructions Breathing Breath hold in inspiration Slice thickness 0.7-1.5mm Scan phases: Pre contrast Are performed for calcium scoring rate Arcus aorta to left hemi diaphragmatic angle Note Note Pac’s system (Syngovia in 128 slice CT scan) is need for calculation of coronary calcifications
- 14. ECG Gated
- 15. Additional ? For single Detector(slice) CT able to do CECT (arterial & venus phase) ? 16 Detector (Slice) can do all contrast CT exam (Brain & coronary CTA) ? 64 Detector(slice) and up cant do all the CT scan procedure ? G 18 iv cannula is brachial vein suggested for Abdomen & Chest CECT ? Flow rate should be 3 – 6ml/sec ? GFR should be seen and ask for contrast allergic and should remove metallic material from scan area ? A satisfactory written consent & allergy form must be taken from the patient or relative of the patient before entering the scanner room ? Contrast agents : Rectal , oral and intravenous contrast
- 16. Thanks
Editor's Notes
- #8: Picture for pda……