UNMH
CT CHEST/ABDOMEN AND PELVIS PROTOCOLS
16 and 10 slice modified protocols

# NAME AND PARAMETERS TECHNIQUE
1 ABDOMEN ( Routine Protocol)  
  KV/effective mAs/rotation time: 120/200/0.5
  Detector collimation (mm): 1.5 mm
  Slice Thickness (mm): 3.0 mm
  Feed / Rotation (mm): 24.0
  Kernel: B30f
  Increment (mm): 3.0
  Image order:  Cranial to caudad.  Image from above diaphragm to greater trochanters.  One acquision.
  Oral Contrast: 750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  RediCAT for outpatients.
  IV Contrast:   100 cc Ultravist 300 at 3cc/sec
  Scan Delay:  75 sec.
  Reconstruction Filming: Oral contrast on table.  Second recon:  kernel 80 lungs only.  film both kernel, every image 20:1
     

 2 

ABDOMEN (Acute abdomen, r/o appy, 
abscess, diverticulitis......)
 
  KV/effective mAs/rotation time: 120/200/0.5
  Detector collimation (mm): 1.5 mm
  Slice Thickness (mm):  3.0 mm
  Feed / rotation (mm):  24.0
  Kernel: B30f
  Increment (mm): 3.0
  Image order:  Cranial to caudad.  Image from above diaphragm to greater trochanters.  Single acquision.  
  Oral contrast: 750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  RediCAT for outpatients.  
  IV contrast: 100 cc  Ultravist 300 at 3cc/sec
  Rectal contrast:  Water soluble rectal contrast before topogram
  Scan Delay:  75 sec
  Reconstruction Filming: Oral contrast on table.  Second recon lung kernel, print all images, 20:1

3

ABDOMEN CTA ROUTINE (AAA)
KV/effective mAs/rotation time: 120/200/0.5
Detector collimation (mm): 1.5 mm
Slice Thickness (mm):  3.0 mm
Feed / Rotation (mm) 12.0
Kernel:  B30f
Increment (mm):  3.0 mm
Image order:  Cranial to caudad
Oral contrast:  None
Intravenous contrast:  100 - 120cc at 3.0 cc/sec
Scan Delay:   CARE Bolus tracking.  Threshold at 120 HU
Comment: Print every image, 20:1, Autoload into 3D

4

 ABDOMEN (Evaluate pelvic malignancy ~ Smith protocol)  
  KV/effective mAs/rotation time:  120/200/0.5
  Detector collimation (mm):  1.5 mm
  Slice Thickness (mm): 3.0 mm
  Feed / Rotation (mm): 24.0
  Kernel:  B30f
  Increment (mm): 3.0
  Image order:  Cranial to cuadad.  Image from above diaphragm to greater trochanters.  Single acquision.  
  Oral contrast:  750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  RediCAT for outpatients. 
  IV contrast: 100 cc Ultravist 300 at 3 cc/sec
  Rectal contrast:  Water soluble rectal contrast before topogram.  Tampon placed by patient. 
  Scan Delay: 75 sec
  Reconstruction Filming Oral contrast on table.  Second recon lung kernel, print all images, 20:1
     

5

 MESENTERIC CTA (R/O Intestinal Ischemia)  
  KV/ Effective mAs/Rotation time (sec) 120/200/0.5
  Detector Collimation (mm) 0.75
  Slice Thickness (mm) 1
  Feed/Rotation (mm) 12
  Kernal (for initial reconstruction) B30f
  Increment (mm) 1
  Image order Cranial - Caudal
  Oral contrast Water 250 cc every 30 min for total of 750 cc + 250 on table.   (If emergent can give 750 cc H20 30 minutes prior + 250 on table)
  IV contrast  Ultravist 300 - 120 cc
  Injection Rate 3.5 - 4 cc second
  Scan Delay (sec) FIRST  acquisition 30 - 35 seconds approximately.  MUST USE CARE BOLUS.  SECOND acquisition 70 second delay.  
Reconstruction / Filming First acquisition reconstruction 1 x 1 to PACS only.  First acquisition 2nd Recon  and second acquisition B30f 3 x 3.  Film every image abdomen windows 20 on 1.  
  Additional Instructions Scan abdomen and pelvis.  Perform thin MIP reformatting using 3D card:  Image thickness 3, Distance between images 1, Number of slices 80 or whatever is needed to cover from anterior vertebral body to abdominal wall at L-2 level.  

6

LIVER THREE PHASE (r/o hepatoma)    NATIVE           ARTERIAL       VENOUS
  KV/effective mAs/rotation time: 120/200/0.5         120/200/0.5         120/200/0.5 
  Detector collimation (mm):  1.5 mm                    1.5 mm             1.5 mm
  Slice Thickness (mm):           5.0 mm                     3.0 mm            3.0 mm
  Feed / Rotation (mm):  12.0                         12.0                 12.0
  Kernel:   B30f                         B30f                 B30
  Increment (mm):  5.0 mm                    2.0 mm              2.0 mm
  Image Order:  Cranial to caudad.  Above diaphragm to the iliac crest.
  Oral contrast:  750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  RediCAT for outpatients.  
  IV contrast:  150 cc Ultravist 300 at 3cc/sec
  Scan Delay:  Initial /25 sec arterial /75 sec venous
  Reconstruction Filming: Film both kernels, every image, 20:1

7

LIVER  (r/o hemangioma)    NATIVE            ARTERIAL                                    
  KV/effective mAs/rotation time: 20/200/0.5            120/200/0.5                                        
  Detector collimation (mm):  1.5 mm                  1.5 mm                                               
  Slice Thickness (mm):           5.0 mm                   3.0 mm                                           
  Feed / Rotation (mm):  12.0                        12.0                                                  
  Kernel:   B30f                        B30f                                                
  Increment (mm):  5.0 mm                    2.0 mm                                            
  Image Order:  Cranial to caudad.  Scan liver without in 5's to find lesion.  Administer IV contrast.  Serial scanning at 45 sec. delay and then every 15 seconds for 3 minutes, then 10 min or as needed.
  Oral contrast:  750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  RediCAT for outpatients.  
  IV contrast:  100 cc Ultravist 300 at 3cc/sec
  Scan Delay:  Initial /45 delay seconds
  Reconstruction Filming: Film both kernels, every image, 20:1

8

PANCREAS THREE PHASE (r/o pancreatitis, pancreatic mass, pseudocyst ) NATIVE                ARTERIAL             VENOUS
  KV/effective mAs/rotation time: 120/200/0.5            120/200/0.5              120/200/0.5
  Detector collimation (mm): 1.5 mm                   1.5 mm                       1.5 mm
  Slice Thickness (mm):  3.0 mm                   3.0 mm                       3.0 mm
  Feed / Rotation (mm):   12.0                       12.0                            12.0
  Kernel:                         B30f                      B30f                            B30
  Increment (mm):      1.5 mm                  1.5 mm                         1.5 mm
  Image order:  Cranial to caudad.  Image from 11th vertebral body through renal hila.
  Oral contrast: 750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  RediCAT for outpatients.
  IV contrast:  150 cc Ultravist 300 at 3 cc/sec
  Scan Delay:  Initial / 25 sec arterial /75 sec venous
  Reconstruction Filming: Film three phases, all images, 20:1

9

 KIDNEY FOUR PHASE (r/o mass NATIVE    ARTERIAL   VENOUS   DELAY
  KV/effective mAs/rotation time:    ALL SAME AT 120/200/0.5
  Dectector collimation:  ALL SAME AT 1.5 mm
  Slice Thickness (mm): ALL SAME AT 3.0
  Feed / rotation (mm): :   ALL SAME AT 12.0
  Kernel:    B30f             B30                B30           B30
  Increment (mm):   5.0                2.0                 2.0             2.0
  Image order:  Cranial to caudad
  Oral contrast:   750 cc RediCAT
  IV contrast:  100 cc Ultravist 300 at 3 cc/sec
  Scan Delay:   Initial/25 sec arterial/ 50 sec venous / 240 sec excretory
  Reconstruction Filming:  Film all phases, every image 20: 1

10

 KIDNEY:  Single Phase (r/o stone)  
  KV/effective mAs/rotation time:  120/200/0.5
  Detector collimation (mm): 1.5 mm
  Slice Thickness (mm):  3.0 mm
  Feed / rotation (mm):  24.0
  Kernel: B30f
  Increment (mm):  2.0 mm
  Image order:  Cranial to caudad
  Oral contrast None
  IV contrast None
  Scan Delay: None
  Reconstruction Filming Print all images, 20:1
11

ADRENAL CT (r/o adrenal adenoma, r/o adrenal metastases)

KV / Effective mAs/Rotation time (sec) 120/130/0.5
Detector Collimation (mm) 1.5
Slice Thickness (mm) Non-contrast 2, with contrast 2
Feed/Rotation (mm) 15
Kernal (for initial reconstruction) B30f
Increment (mm) Non-contrast 2, with contrast 2
Image order  Cranial - Caudal
Oral Contrast None
IV Contrast Ultravist 300 - first run without IV contrast then measure HU of adrenal mass, If >10, give 100 cc Ultravist
Injection Rate 2 - 3 cc second
Scan Delay (sec)  30 seconds 2nd scan (acquisition) 
15 MINUTES 3rd Scan (acquisition)
Reconstruction / Filming Non-contrast reconstruction 2 x 2 with B30f.  Film every image in 20 on 1, With IV contrast 2nd and 3rd acquisition reconstruction 2 x 2 B30f.  Film every image 20 on 1.  

12

THORACIC AORTA (Thoracic aortic dissection / aneurysm  
  KV/effective mAs/Rotation Time (sec) 120/130/0.5 (Increase mAs for large patients, may increase to 200)
  Detector collimation (mm) 1.5
  Slice Thickness (mm) non-contrast 5, with contrast 2
  Feed/Rotation (mm) 18  (10 slice), 24 non-contrast and 18 contrast  (16 slice)
  Kernel (for initial reconstruction) B30f
  Increment (mm) Non-contrast 5, with contrast 1
  Image order Cranial-Caudal
  Oral Contrast None
  IV contrast Ultravist 300 - First run without IV contrast them repeat using 120 cc
  Injection Rate  3-4 cc second
  Scan delay (sec) 25-30 seconds approximately   MUST USE CARE BOLUS
  Reconstruction/Filming Non-contrast reconstruction 5 x 5 with B30f and B80f.  Film every image in 20 on1
With IV contrast, initial reconstruction 2 x 1 B30f.  Film every other window 20 on 1.

13

 CHEST/ABDOMEN/PELVIS 
(ONCOLOGY FOLLOW-UP)
KV/effective mAs/rotation time: 120/200/0.5
Detector collimation (mm):  1.5 mm
Slice Thickness (mm): 3.0 mm
Feed / Rotation (mm): 24.0
Kernel:  Abdomen B30f/Lung 80/Bone B31f
Increment (mm):  3.0 mm
Image order:  Cranial to caudal.  Lung apices to the greater trochanters.
Oral contrast:  750 cc dilute gastrograffin
IV contrast:  100 cc Ultravist 300 at 3 cc.sec
Scan Delay:   25 sec for chest/ 75 sec abdomen
Comment:  Film lung, soft tissue and bone kernels, every image, 20:1

14

 LUNG (Evaluate lung nodule(s)  
  KV/Effective mAs/Rotation time: 120/130/0.5
  Detector collimation (mm) 1.5
  Slice Thickness (mm) 5
  Feed / rotation (mm) 18 (10 slice)    24 (16 slice)
  Kernel (for initial reconstruction) B40f
  Increment (mm) 5
  Image order Cranial to Caudal
  Oral Contrast  None 
  IV contrast: None
  Scan Delay: None
  Reconstruction/Filming Initial recon 5 x 5 B41f, film every image in mediastinal window.  2nd reconstruction 2 x 2 B80f, film every image 20 on 1.

15

 LUNG ( Infection, Lung Carcinoma Eval)  
  KV/effective mAs/rotation time: 120/130/0.5
  Detector collimation (mm): 1.5 mm
  Slice Thickness (mm): 5
  Feed  / rotation: 18 (10 slice)    24 (16 slice)
  Kernel (for initial reconstruction): B30f
  Increment (mm): 5
  Image order: Cranial to caudad
  Oral contrast: RediCAT or dilute gastrograffin 200 cc on table
  IV contrast: Ultravist 120 cc,  2-3 cc /sec
  Scan Delay: 25-28 seconds approximately, Use care bolus if patient has cardiac disease
  Reconstruction/Filming Initial reconstruction 5 x 5 film every image mediastinal window 20 on 1.  2nd Reconstruction 3 x 3 B80f , film every image, lung windows 20 on 1
     

16

 PLEURAL/CHEST WALL (Evaluate empyema / Assess malignant pleural disease)  
  KV/effective mAs/rotation time: 120/100/0.5
  Detector Collimation (mm) 1.5
  Slice Thickness (mm) 5
  Feed/rotation (mm) 18 (10 slice)  24 (16 slice)
  Rotation time 0.5 sec
  Kernel (for initial reconstruction) B40f
  Increment (mm) 5
  Image order Cranial to Caudal
  Oral Contrast: RediCAT or dilute gastrograffin 200 cc on table
  IV contrast Isovue 300, 2-3 cc second
  Scan Delay 25 seconds - Pulmonary arterial phase,  **  If follow-up study for Empyema, may skip arterial phase.   90 seconds - Pleural phase
  Reconstruction/Filming Pulmonary artery phase 5 x 5, film every image mediastinal and lung window 20 on 1
Pleural phase 5 x 5 mediastinal windows only.  Film every image 20 on 1.

18

PULMONARY EMBOLISM  (R/O PE)  
  KV / Effective mAs/Rotation time (sec) 120/130/0.5 (Increase mAs for large patients, may increase to 200)
  Detector Collimation (mm) 0.75
  Slice Thickness (mm) 1
  Feed/Rotation (mm) 11.2 (10 slice)   15 (16 slice)
  Kernel (for initial reconstruction) B30f
  Increment (mm) 1
  Image order Cranial  to Caudal
  Oral Contrast None
  IV contrast Ultravist 300  - 120 cc
  Injection Rate 3.5-4 cc second
  Scan Delay (sec) 22-28 seconds approximately  (MUST USE CARE BOLUS)
  Reconstruction / Filming Initial reconstruction 1 x 1 to PACS only
2nd Recon B30f 3 x 3, film every image mediastinal windows 20 on 1
3rd Recon 5 x 5 B80, film every image lung windows 20 on 1
  Additional Instructions Cover entire chest in scan.  DO NOT scan chest without contrast
     

20

 HIGH RESOLUTION CT I (Evaluate diffuse lung disease ) Emphysema, UIP, PCP etc.)  
  KV/effective mAs/rotation time: 120/130/0.75
  Detector Collimation (mm) 0.75
  Slice Thickness (mm) 5
  Feed/Rotation (mm) 11.2 (10 slice)    12 (16 slice)
  Kernel (for initial reconstruction) B31s
  Increment (mm) 5
  Image order Cranial to Caudal
  Oral Constrast None
  IV contrast None
  Scan Delay (sec) None
  Reconstruction/Filming Initial reconstruction 5 x 5.  Film every image mediastinal and lung window 20 on 1
2nd recon B80s 1 x 1.  Film every 5th image in lung windows 20 on 1
  ADDITIONAL EXPIRATORY, USE SEQUENCE MODE
  KV/effective mAs / rotation time: 120/100/0.75
  Detector collimation (mm) 1mm
  Slice width 1mm
  Feed/Scan (not Feed/Rotation) 11.2 (10 slice)   12 (16 slice)
  Rotation time 0.75 sec
  Kernel B80s
    REPEAT PRONE IN INSPIRATION
  KV / Effective mAs/Rotation time: 120/100/0.75
  Detector Collimation (mm) 1mm
  Slice Width 1mm
  Feed/Scan (Not Feed/Rotation) 15 mm
  Rotation time 0.75 sec
  Kernel B80s
     

21

HIGH RESOLUTION CT II (Bronchiectasis, hemoptysis  
  KV/Effective mAs/Rotation time (sec) 120/130/0.75
  Detector Collimation (mm) 0.75
  Slice Thickness (mm) 5
  Feed/Rotation (mm) 11.2 (10 slice)   12 (16 slice)
  Kernel (for initial reconstruction) B31s
  Increment (mm) 5
  Image order Cranial to Caudal
  Oral Contrast None
  IV Contrast None
  Scan Delay (sec) None
  Reconstruction/filming Initial reconstruction 5 x 5.  Film every image mediastinal and lung window 20 on 1.  
2nd recon B80s 1 x 1.  Film every 5th image in lung windows 20 on 1.
  ADDITIONAL EXPIRATORY (NO Prone Images)
  KV/effective mAs/Rotation time (sec) 120/100/0.5
  Detector Collimation (mm) 1 mm
  Slice width 1 mm
  Feed Scan (Not Feed/Rotation) 15 mm
  Rotation time 0.75 sec
  Kernel B80s
22 CT UROGRAM NATIVE            ARTERIAL      VENOUS
KV/effective mAs/rotation time:    ALL SAME AT 120/200/0.5
Dectector collimation:  ALL SAME AT 1.5 mm
Slice Thickness (mm): ALL SAME AT 3.0
Feed / rotation (mm): :   ALL SAME AT 12.0
Kernel:    B30f                B30                           B30                       
Increment (mm):   5.0                   2.0                            2.0                        
Image order:  Cranial to caudad
Oral contrast:   750 cc RediCAT
IV contrast:  100 cc Ultravist 300 at 3 cc/sec
Scan Delay:   Initial/25 sec arterial/ 50 sec venous / 240 sec excretory
Reconstruction Filming:  Film all phases, every image 20: 1
Comments:  Transfer patient to Fluoroscopy for evaluation of  ureters 
 TRAUMA PROTOCOLS

T1

TRAUMA ABDOMEN AND PELVIS (MCV) Trauma #1
KV/effective mAs/rotation time:  120/200/0.5
Detector collimation (mm) 1.5 mm
Slice Thickness (mm):  3.0 mm
Feed / Rotation (mm):  24.0
Kernel:  Abdomen B30f / Lung 80/Bone B31f
Increment (mm):  3.0 mm
Image order:  Cranial to caudad.  Above diaphragm to the greater trochanters.  No delay between abdomen and pelvis.  
Oral contrast:  750 cc dilute gastrograffin for ER / inpatients or suspected perforation.  Oral dose on table. 
IV contrast: 100 cc Ultravist 300 at 3cc/sec
Scan Delay:  75 sec
Comment:  Film lung, soft tissue and bone kernels, every other image, 20:1

T2

TRAUMA ABDOMEN AND PELVIS (STABBING) Trauma #2
KV/effective mAs/rotation time:  120/200/0.5
Detector collimation (mm):  1.5 mm
Slice Thickness (mm):   3.0 mm
Feed / Rotation (mm):  24.0
Kernel:  Abdomen B30f/Lung 80/Bone B31f
Increment (mm):  3.0 mm
Image order:  Cranial to caudal.  Image from above diaphragm
Oral contrast:  750 cc dilute gastrograffin for ER / inpatients or suspected perforation
Rectal contrast:  1.5 dilute water soluble contrast before topogram.  
IV contrast:  100 cc Ultravist 300 at 3 cc/sec
Scan Delay:   75 sec
Comment:   Film lung, soft tissue and bone kernels, every image, 20:1
     

T3

TRAUMA CHEST/ABDOMEN/PELVIS (r/o injury)
KV/effective mAs/rotation time: 120/200/0.5
Detector collimation (mm):  1.5 mm
Slice Thickness (mm): 3.0 mm
Feed / Rotation (mm): 24.0
Kernel:  Abdomen B30f/Lung 80/Bone B31f
Increment (mm):  3.0 mm
Image order:  Cranial to caudal.  Lung apices to the greater trochanters.
Oral contrast:  750 cc dilute gastrograffin
IV contrast:  100 cc Ultravist 300 at 3 cc.sec
Scan Delay:   25 sec for chest/ 75 sec abdomen
Comment:  Film lung, soft tissue and bone kernels, every image, 20:1

T4

CT CYSTOGRAM (r/o injury) May be performed in conjunction with trauma abd/pelvis
KV/effective mAs/rotation time:  120/200/0.5
Detector collimation (mm):  1.5 mm
Slice Thickness (mm): 3.0 mm
Feed / Rotation (mm):   24.0
Kernel:  Abdomen B30f/Bone B31f
Increment (mm):  3.0 mm
Image order:  Cranial to caudad.  Iliac crest to greater trochanters. 
Oral contrast:  See trauma protocol if applicable
IV contrast:  See trauma protocol if applicable 
Cystogram:   25 cc Reno 60 in 500 cc saline bag.  Drip rapidly into bladder for minimum 350 cc prior to scan. 
Scan delay:  None
Comment:   Film soft tissue and bone kernels, every other image, 20:1

 

SCANNER TABLE WEIGHT LIMIT
UNMH Siemens Somatom Emotion 16 slice 450 lbs distributed weight
UNMH Siemens Somatom Emotion 10 slice 450 lbs distributed weight
VAMC Marconi (Picker) PQ-6000 400 lbs distributed weight
VAMC Siemens Somatom 16 slice 450 lbs distributed weight

new protocol test