CT AORTA – POST ENDOGRAFT

INDICATIONS: AAApost endograft repair.“CTA: Aorta, PE. No need to do pre unless looking for acute intramural hematoma or looking at stent grafts.”

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

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

ORAL CONTRAST: None

POSITIONING: Feet First Supine, Arms above head

TOPOGRAMS: AP. Range: Dome of diaphragm through symphysis pubis. 35 mA, 120 kV

SCAN TYPE: Spiral/Helical

NOTES: FOR ENDOGRAFT ONLY: Do UnEnhanced Series. Also do Delay Series through the graft area to check for a leak.

Obtain Order for CT Angio Abdomen & Pelvis

Send Arterial Recon 3-D 0.6x0.3mm to Vital Workstation for 3D.

Bill for 3D (No Charge)

ALARA – Keep radiation dose As Low As Reasonable Achievable.

CARE BOLUS triggered scan.

100 kV on Arterial scan unless extra-large, then 120 kV

NONCONTRAST – ENDOGRAFT ONLY

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed:
(mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Dome of Diaphragm Through
Symphysis Pubis / Craniocaudal
Spiral/Helical / Suspended Inspiration / 5
Seconds / ON / 120 / ON / 120 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.8
Table Increment/Speed:
15.36 mm/rotation / 0.5
seconds / 50
cm
Plane / SAFIRE
Strength / Slice Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body

MONITORING

ScanRange
CARE BOLUS
Monitoring Location / Scan Direction
Scan Type
Number of Scans / Respiration / Threshold / Scan
Delay
Seconds / CARE
DOSE
4D / mAs / CARE
kV / kV / Detector Configuration
Slices Per Tube Rotation / Table
Feed / InterScan
Delay
(CycleTime)
Seconds / Scan
Time
Seconds / SFOV
(cm)
Single Slice
Abdominal Aorta
First Slice of Arterial Scan / Craniocaudal
Sequential
30 scans / Quiet
Respiration / 150 HU / 15
Seconds / OFF / 40 / OFF / 120 / Detectors: 1 x10.0 mm
Slices Per Tube Rotation: 1 / 0.0 mm / 1.5
Seconds / Full
0.5 Sec / 50
cm
Plane / Slice
Thickness / Interval/
Table Feed / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / 10.0 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 / Scan
Direction/
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / Dectector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed:
(mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Dome of Diaphragm
Through
Symphysis Pubis / Craniocaudal
Spiral/Helical / Suspended
Inspiration / CARE BOLUS Tracking
(Trigger 150 HU)
Plus 6 Second Delay / ON / 120 / Semi / 100 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 1.4
Table Increment/Speed:
26.88 mm/rotation / 0.5
seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 2.0 mm / 2.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – AXIAL LUNG / Axial / ON
2 / 1.0 mm / 1.0 mm / B70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – 3D – AXIAL SOFT TISSUE
Send to Vital Workstation for 3D / Axial / ON
3 / 0.6 mm / 0.3 mm / I26f
Medium Smooth / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 2.0 mm / 2.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – SAGITTALSOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 2.0 mm / 2.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – CORONAL MIPS
Coronals Angled in Plane to Body Part / Coronal MIPS Angled in Plane to Body Part. Recon Card 3D Coronal MIP Thin / ON
3 / 10.0 mm / 2.0 mm / I40f
Medium / CT Angio
700/80 / FOV just beyond
patient’s body
RECON – SAGITTAL MIPS
Sagittals Angled in Plane to Body Part / Sagittal MIPS Angled in Plane to Body Part. Recon Card 3D Sagittal MIP Thin / ON
3 / 10.0 mm / 2.0 mm / I40f
Medium / CT Angio
700/80 / FOV just beyond
patient’s body

DELAY – ENDOGRAFT ONLY

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed:
(mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Through Endograft
Area Only / Craniocaudal
Spiral/Helical / Suspended
Inspiration / 120 sec. from
Start of Injection.
(Approximately 90 sec From End of Arterial) / ON / 120 / ON / 100 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 1.4
Table Increment/Speed:
26.88 mm/rotation / 0.5
seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
Approximate Values for CTDIvol
Patient Size / Weight (kg) / Weight (lbs) / CTDIvol (mGy)
Small / 50-70 / 110-155 / 10-17
Average / 70-90 / 155-200 / 15-25
Large / 90-120 / 200-265 / 22-35
Reference: AAPM

*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.

Allowed CTDIvol Dose Ranges:3 mGy – 50 mGy

XR29 Dose Notification Value (CTDIvol):50 mGy

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*The AAPM recommended NEMA XR29 Dose Notification Value for an adult torso is 50 mGy. Dose notification levels less than the AAPM recommended can be set. 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. Send Arterial Recon 3D 0.6x0.3mm to Vital Workstation for 3D

5/2018Page 3 of 3