Chest: Difference between revisions
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Latest revision as of 10:03, 3 April 2024
| Indication | Brief description | Slice thickness and reconstruction kernel | Further details of contrast timing/explanation of what the radiographers do | Abbreviation |
|---|---|---|---|---|
|
ENT cancer staging chest |
CT chest (contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
65 seconds |
CT chest + c |
|
Lung cancer staging |
CT chest and abdomen (contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
65 seconds |
CT chest and abdo + c |
|
Nodule on chest x-ray or nodule follow up |
CT chest limited through nodule (non-contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
No contrast |
Limited CT chest |
|
Pulmonary embolus? |
CTPA |
1 mm B26f, 1 mm B70f both 0.7 mm increment. Vascular windows: C:200 W:600 |
ROI placed over main PA monitoring begins after 4 seconds and bolus tracking triggers scan at 140 HU with a delay of 6 seconds. Or Flash CTPA. |
CTPA |
|
Interstitial lung disease? Bronchiectasis, rheumatoid arthritis, fibrosis, sarcoidosis, fungal infection, PCP? |
CT chest volume (non-contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
No contrast |
Non-contrast CT chest |
|
Mesothelioma? Empyema/unilateral pleural effusion? |
CT pleural disease (65 s contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Scan at 65 seconds post contrast. |
CT chest + c |
|
Mesothelioma follow-up |
CT chest & abdomen (contrast) mesothelioma protocol |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Scan at 65 seconds post contrast. |
CT chest and abdo + c |
|
Mediastinal mass |
CT chest + c |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Scan at 65 seconds post contrast. |
CT chest + c |
|
Fungal infection? |
CT chest (non-contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
No contrast |
Non-contrast CT chest |
|
For left atrial ablation |
CT left atrium (contrast) |
Now done by cardiology |
CTLA | |
|
Post-sternotomy. Infection? |
CT sternum (65 s contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
65 seconds post contrast. |
CT chest + c |
|
For anatomy prior to re-do sternotomy |
CT sternum (non-contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
No contrast |
Non-contrast CT chest |
|
Pneumothorax? Pneumothorax vs bulla |
CT chest volume (non-contrast) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
No contrast |
Non-contrast CT chest |
|
Aortic dissection? Aneurysm? Acute aortic syndrome |
CT angiogram aorta |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Pre contrast aorta followed by cardiac gated CT angiogram or Flash (high pitch) angiogram of the aorta. |
Gated CT aorta Flash CT aorta See appendix |
|
Ruptured aortic aneurysm |
Pre/arterial |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Pre-contrast, angio (bolus tracked) |
Angio aorta inc pre con |
|
Post aortic dissection/aneurysm/EVAR repair first follow up |
CT angiogram aorta with pre-contrast |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Bolus tracking with ROI over descending aorta triggers at 100 HU with 6 second delay |
CT aorta pre and angio |
|
Post aortic repair surveillance |
CT angiogram aorta or MRI, no pre-contrast |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
As above |
CT angio aorta |
|
Endoleak? |
Pre and arterial covering stented aorta. If no leak, but continued sac expansion/type V suspected the 60 second delay |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
As above |
CT aorta pre and angio (specify which part of aorta) |
|
Acute aortic syndromes |
Gated CT angiogram aorta |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Pre contrast aorta followed by wide prospective cardiac gated CT angiogram of ascending aorta with CT or Flash CT (high pitch) angiogram of the aorta. |
Gated CT angio aorta with pre-contrast |
|
Aortic coarctation? |
CT angiogram aorta |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
Bolus tracking with ROI over descending aorta triggers at 100 HU with 6 second delay |
CT aorta |
|
Pre-operative aortic diameter/calcification |
CT ascending aorta (non-contrast top of arch to mid heart) |
1 mm B30f, 1 mm B70f both 0.7 mm increment. |
No contrast |
CT non-con ascending aorta |
|
Tb? |
Indicated for suspected Tb, but uncertain clinical diagnosis, consider contrast if nodal disease is the main query |
1 mm slice width, 1 mm increment |
Insert text here |
CT chest |
|
Tb response to treatment? |
Indicated where response is uncertain, consider contrast if nodal disease is the main query |
1 mm slice width, 1 mm increment |
Insert text here |
CT chest |
|
Ocular Tb or other extrapulmonary Tb |
Consider chest radiograph instead. For example in ocular Tb/Tb uveitis 60% do not have pulmonary Tb and further imaging may not enhance diagnostic pathway as it will not be sensitive for extra pulmonary disease detection and will not have a high negative predictive value for extrapulmonary disease. |
N/A |
N/A |
N/A
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