CT ENTEROGRAPHY

INDICATIONS: SINGLE PHASE: Most cases of Crohn’s disease, all patients younger than 50, screening for Iron Deficiency Anemia in patientsUNDER 50

DUAL PHASE: Mesenteric Ischemia, Acute GI Bleed (under 50 check with radiologist), Iron Deficiency Anemia in patients OVER 50.

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

IV CONTRAST: Perform as directed by the supervising radiologist.

SINGLE PHASE:100mL Isovue 370 @ 3.0mL/second

DUAL PHASE: 125mL Isovue 370 @ 4.0 mL/second

ORAL CONTRAST: 1 Bottle BREEZA (500mL)60 minutes prior to scan

1 Bottle BREEZA (500mL)40 minutes prior to scan

½ Bottle BREEZA (250mL)20 minutes prior to scan

½ Bottle BREEZA (250mL)Immediately prior to scan

Then have patient walk around. Position patient in right lateral decubitus for one minute to empty contrast out of stomach. Then scout.

*Note: When instructing patients, coach the patients to drink continuously and not gulp it at the end or chug it in the beginning and wait until the

next 20 minutes. It should take them 20 minutes to drink the entire bottle. Have patient void prior to prep.

POSITIONING: Feet First Supine, Arms above head

TOPOGRAMS: AP. Range: Dome of diaphragm through ischial tuberosities. 35 mA, 120 kV

SCAN TYPE: Spiral/Helical

NOTES: ALARA – Keep radiation dose As Low As Reasonably Achievable.

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

PERFORM CONTROL SCAN AT UMBILICUS TO ASSESS DISTENTION
IDEALLY 3+ CM BOWEL DISTENTION

CONTROL SCAN

Scan
Range / Scan Direction
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / kV / Detector Configuration
Slices Per Tube Rotation / Table
Feed / Cycle
Time
(Seconds) / Scan
Time
(Seconds) / SFOV
(cm)
Single slice at
Umbilicus / Craniocaudal
Sequential / Suspended
Inspiration / 5
Seconds / ON / 120 / OFF / 120 / Detectors: 1 x5.0 mm
Slices Per Tube Rotation: 1 / 0.0 mm / 0.75
Seconds / Full
0.5 Sec / 50
cm
Plane / Slice
Thickness / Interval/
Table Feed / Kernal / Window
Width/Level / DFOV
(cm)
RECON / Axial / 5.0 mm / 0.0 mm / B40s
Medium / Abdomen
300/40 / FOV just beyond
patient’s body

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ENTEROGRAPHY – SINGLE PHASE

Scan
Range / Scan
Direction / 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
Ischial Tuberosities / Craniocaudal / Suspended
Inspiration / 70
Seconds / ON / 120 / ON / 120 / Detectors: 64 x0.6 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 / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON / Axial / ON
2 / 3.0 mm / 3.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – CORONAL MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON - SAGITTAL MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 3.0 mm / 3.0 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 / Abdomen
300/40 / FOV just beyond
patient’s body

ENTEROGRAPHY – DUAL PHASE

ARTERIAL

Scan
Range / Scan
Direction / 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
Ischial Tuberosities / Craniocaudal / Suspended
Inspiration / 39
Seconds / ON / 120 / ON / 120 / Detectors: 64 x0.6 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 / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – CORONAL MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON - SAGITTAL MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 3.0 mm / 3.0 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 / Abdomen
300/40 / FOV just beyond
patient’s body

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VENOUS

Scan
Range / Scan
Direction / 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
Ischial Tuberosities / Craniocaudal / Suspended
Inspiration / 70 Seconds From
Start of Injection
(Approximately 20 sec
From End of Arterial) / ON / 120 / ON / 120 / Detectors: 64 x0.6 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 / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON / Axial / ON
2 / 3.0 mm / 3.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – CORONAL MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON - SAGITTAL MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 3.0 mm / 3.0 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 / 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

Allowed CTDIvol Dose Ranges:7 mGy – 50 mGy

XR29 Dose Notification Value (CTDIvol):50 mGy

*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: CENTER

NETWORK: Exam to PACS

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