INDICATIONS:Aneurysm

CT HEAD ANGIO

INDICATIONS:Aneurysm

PATIENT PREP:NPO for solid foods, water only, for 4 hours prior to scan

IV CONTRAST:100mL Isovue 370 @ 4-5 mL/second

ORAL CONTRAST:None

POSITIONING:Head First Supine.

Position the patient’s head to superimpose the supraorbital ridge and the inner table of the skull at the foramen magnum along a line.

(Axial Plane: 25 degrees Caudad to Reid’s Baseline)

TOPOGRAMS:AP. Range: Topogram from top of head through aortic arch. 25 mA, 110 kV

Lateral. Range: Topogram from top of head through aortic arch. 25 mA, 110 kV

SCAN TYPE:Spiral/Helical

NOTES:Perform NonContrast scan on most exams. Check with radiologiston patients with recent CT/MR Head scans, young patients, or follow-upaneurysm.

Send Recon 3D 0.75 x 0.4mm to Vital Workstation for 3D. Add charge for 3D (No Charge)

CARE BOLUS triggered Arterial scan.

ALARA – Keep radiation dose As Low As Reasonably Achievable.

NONCONTRAST

Scan
Range / Scan Direction
Scan Type / Respiration / Scan Delay / CARE
DOSE
4D / Effective
mAs / kV / Detector Configuration
Slices Per Acquisition / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Base of Skull
Through Vertex / Caudocranial
Spiral/Helical / Quiet
Respiration / 3
Seconds / OFF / 240 / 130 / Detectors: 16 x 0.6 mm
Slices Per Tube Rotation: 16 / Pitch: 0.8
Table Increment/Speed: 7.68 mm/rotation / 1.0
Seconds / 30
cm
Plane / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE
Axial / Axial Plane: 25 degrees Caudad to Reid’s Baseline – Superimpose the supraorbital ridge and the inner table of the skull at the foramen magnum along a line / 5.0 mm / 5.0 mm / H30s
Medium Smooth / Cerebrum
80/35 / FOV just beyond
Patient’s head
RECON – AXIAL BONE
Axial / Axial Plane: 25 degrees Caudad to Reid’s Baseline – Superimpose the supraorbital ridge and the inner table of the skull at the foramen magnum along a line / 5.0 mm / 5.0 mm / H70h
Sharp FR / Osteo
1500/450 / FOV just beyond
Patient’s head
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / 5.0 mm / 5.0 mm / H30s
Medium Smooth / Cerebrum
80/35 / FOV just beyond
Patient’s head
RECON – SAGITTAL SOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / 5.0 mm / 5.0 mm / H30s
Medium Smooth / Cerebrum
80/35 / FOV just beyond
Patient’s head

MONITORING

ScanRange
CARE BOLUS
Monitoring Location / Scan Direction
Scan Type
Number of Scans / Respiration / Threshold / Scan
Delay
Seconds / CARE
DOSE
4D / mAs / kV / Detector Configuration
Slices Per Tube Rotation / Table
Feed / InterScan
Delay
(CycleTime)
Seconds / Scan
Time
Seconds / SFOV
(cm)
Single slice
Aortic Arch / Craniocaudal
Sequential
30 scans / Quiet
Respiration / 50 HU / 10
Seconds / OFF / 40 / 110 / Detectors: 16 x 0.6 mm
Slices Per Tube Rotation: 1 / 0.0 mm / 1.2
Seconds / Full
0.6Sec / 50
cm
Plane / Slice
Thickness / Interval/
Table Feed / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / 9.6 mm / 0.0 mm / B30s
Medium / Abdomen
300/40 / Small FOV large enough to
Cover region of interest

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ARTERIAL

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Effective
mAs / kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Below Base of Skull
Through Vertex / Caudocranial
Spiral/Helical / Quiet
Respiration / CARE Bolus Tracking
(Trigger 50 HU)
Plus 6 Second Delay / OFF / 100 / 110 / Detectors: 16 x 0.6 mm
Slices Per Tube Rotation: 16 / Pitch: 1.15
Table Increment/Speed:11.04 mm/rotation / 0.6
seconds / 30
cm
Plane / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial Plane: 25 degrees Caudad to Reid’s Baseline – Superimpose the supraorbital ridge and the inner table of the skull at the foramen magnum along a line / 1.0 mm / 1.0 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond
patient’s head
RECON – 3D – AXIAL SOFT TISSUE
Send To Vital Workstation for 3D / Axial Plane: 25 degrees Caudad to Reid’s Baseline – Superimpose the supraorbital ridge and the inner table of the skull at the foramen magnum along a line / 0.75 mm / 0.4 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond
patient’s head
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / 1.0 mm / 1.0 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond
patient’s head
RECON – SAGITTAL SOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / 1.0 mm / 1.0 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond
patient’s head
RECON – CORONAL MIPS
Coronal MIPS Angled in Plane to Body Part / Coronal MIPS Angled in Plane to Body Part
Recon Card 3D Coronal MIP Thin / 5.0 mm / 2.0 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond
patient’s head
RECON – SAGITTAL MIPS
Sagittal MIPS Angled in Plane to Body Part / Sagittal MIPS Angled in Plane to Body Part
Recon Card 3D Sagittal MIP Thin / 5.0 mm / 2.0 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond
patient’s head

*The operator must check the CTDIvol before and after the scan to ensure it is within the allowed dose range. Scans performed outside of the allowed range must be

documented and reviewed by the designated radiologist and/or physicist.

NonContrast Head Allowed CTDIvol Dose Ranges:30mGy – 80 mGy

NonContrast Head XR29 Dose Notification Value (CTDIvol):80 mGy

Arterial Head Allowed CTDIvol Dose Ranges:1 mGy – 80 mGy

Arterial Head XR29 Dose Notification Value (CTDIvol):80 mGy

Note: The Diagnostic Reference Dose (CTDIvol) is 75 mGy (with the 16 cm CTDI phantom). The pass/fail limit (ACR and Washington State) is 80 mGy. Most routine head scans on modern scanners have CTDIvol ranges between 40 and 60 mGy.
*The AAPM recommended NEMA XR29 Dose Notification Value for an adult head is 80 mGy. The maximum CTDIvol should match the dose notification value. Exams with CTDIvol values less than the minimum allowed range should not be performed unless approved by a radiologist.

CHARGES:Bill for 3D in Charges section when ending exam: “3D POST PROCESSING CT”

NETWORK:Exam to PACS

Recon 3D 0.75 x 0.4mm to Vital Workstation for 3D

12/2017 Page 2 of 2