Adult Upper Extremity - (02/08/2018)

CTDI: ~15-20 mGy per acquisition

Billing:

1.  CTA upper Extremity with IV contrast

2.  IV Contrast

Setup: IV access to be obtained in arm contra-lateral to patient’s symptoms

·  Supine, AP scout should be obtained with the patient's symptomatic arm elevated above the head with palm facing up. Rotation of the head turned away from the elevated side, and the contra-lateral arm remains alongside the body

DFOV: Appropriate for patients body habitus. Use same DFOV as prior exam when available.

Scan Parameters:

CTA Upper Extremity with contrast only

Arterial

1.  IV Contrast:

a.  at the discretion of the Radiologist

b.  100 ml of 320- 370 mg/dl non-ionic contrast @ 4.5 ml/sec followed by 50 ml saline chase @ 4.5 ml/sec

c.  If unable to access an 18 gauge, please use a 20 gauge and adjust to 4ml/sec

2.  Smart Prep/Bolus Tracking – start scanning upon entry of contrast into the descending aorta at the level of the aortic arch or trigger at 100 HU

3.  Scan from above below the entire aortic root through the fingers

Reconstructions:

1.  Recon 1 is an axial data set

2.  Recon 2 is for Arterial Phase MIP’s

·  MIP’s should be reconstructed at 1-1.25mm x 1-1.25mm

PACS Series: Topogram, Axial, Sagittal and Coronal MIP’s, Volume MIP and VRT Rotation

Acquisition Parameters
Scanner / Emotion 16 / Sensation 16 / Definition 20 / Sensation 64 / GE 16 / GE 64
Scan Type / Spiral / Spiral / Spiral / Spiral / Spiral / Spiral
Rotation Time (sec) / 0.5 / 0.5 / 0.5 / 0.5 / 0.8 / 0.5
Detector Configuration / 16 x 0.6 / 16 X 0.75 / 20 x 0.6 / 64 x 0.6 / 16 x 1.25 / 64 x 0.625
Pitch / 1 / 1 / 0.9 / 0.75 / 1.75:1 / 1.375:1
Speed(mm/rot) / 35 / 55
Scan FOV / Large / Large / Large / Large / Large / Large
Auto mA range / n/a / n/a / n/a / n/a / 80-300 / 100-500
Noise Index / n/a / n/a / n/a / n/a / 15 / 15
mAs
eff.mAs (care dose) / 150-250 / 150-250 / 150-250 / 150-250
kVp / 110 / 100-120 / 100-120 / 100-120 / 100-120 / 100-120
Manual mA
Reconstruction Parameters
Recon 1 Soft Tissue
Algorithm/ Kernel / B41 / B41 / B41 / B41 / Standard / Standard
WW / 450 / 450 / 450 / 450 / 450 / 450
WL/WC / 35 / 35 / 35 / 35 / 35 / 35
Slice thickness (mm) / 1 / 1 / 1 / 1 / 1.25 / 1.25
Slice Increment (mm) / 1 / 1 / 1 / 1 / 1.25 / 1.25
Recon 2 for MIP’s and VRT’s
Algorithm/ Kernel / B41 / B41 / B41 / B41 / Standard / Standard
WW / 450 / 450 / 450 / 450 / 450 / 450
WL/WC / 35 / 35 / 35 / 35 / 35 / 35
Slice thickness (mm) / 0.6 / 1 / 0.6 / 0.6 / 1.25 / 0.625
Slice Increment (mm) / 0.6 / 0.5 / 0.6 / 0.6 / 0.625 / 0.625