Chest: Difference between revisions

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Ocular Tb or other extrapulmonary Tb
Ocular Tb or other extrapulmonary Tb
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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
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.
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Revision as of 11:17, 10 October 2018

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

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