Pelvic CT scan
Post on 24-Feb-2016
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Pelvic CT scan
Done by:Alia BafqeehNora Alohaly
Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care .
Outlines :
It is an imaging method that uses x-rays to create cross-sectional pictures of the organs inside the pelvis (bladder, prostate, lymph nodes and pelvic bones).
CT scan of the pelvis:
Pelvic truma or fracture . Hematuria or suspected renal calculus.Hematoma. Suspected hemorrhage. Hip osteonecrosis. Ischemic bowel.Pelvic inflammatory or infection disease(abscess/colitis).Pelvic vein thrombosis. Congenital abnormalities e.g. CHD. Tumors, suspected or known (Lymphadenopathy/Primary or
metastatic malignancies)
Indications of pelvic CT :
CHD Ewing sarcoma osteosarcoma of the ilium
There are no absolute contraindications to pelvic CT examinations, the relative benefits should be outweigh the exposure risk.
• Check the following conditions : – ALLERGIES, ASTHMA, DIABETIES, KIDNEY DISEASE
• Ask if a patient is PREGNANT. • Ask about prior reaction to contrast.
Contraindications of pelvic CT :
Pelvic CT scan : In KKUh there are 2 protocols
Truma . Pathology .
Truma protocol (C-) E.g. to rule out fractures or history of truma .
Patient preparation :No need for pt. preparation since he comes directly from the ER . - Pt. should be stable (vital sings).- On stretcher.- No need to be NPO except if a sedation is needed ( NPO for 3-4
hrs). Patient position : -Supine. -Feet first in gantry. -Hands above the head .
- The vertical center is in the middle of the pelvis .
- The axial center is in the iliac crest.
The scanning process :• Scout Images: PA : plane 180º Lat : plane 90º
Type of recons .
DFOV SFOV mA K.V End locat.
Start locat.
Space Thickness Type of scan
Standard 30 – 50 cm
The size of the Pt.
M ,LThe size of the
Pt.
Auto mA 200 - 400
120 Mid of thigh.
L4 2.5
5 Helical
Standard window Bone window
• The serial of procedure :
2nd reconstruction
Bone window fractures.
- When the scan is end we can have 2D reformats (coronal, sagittal ) and 3D pelvis .
pathology protocol (C+) E.g. Ca ovarian , mass or swelling
Patient preparation :
- 60 ml castor oil the night before the procedure. - NPO from mid night . - The patient should be in department 2hrs before start the procedure. - check that pt. not allergic or asthmatic . - Check pt. renal function test ; for inpatient 1 week outpatient (diabetic) 3 months outpatient (non-diabetic) 6 months
- Pt. is given the oral contrast gastrografin or telebrix 3% (30 ml in 1000 ml of water ), one cup every 10 min .
- After 1hr Pt. call and stay in beside room:
Pt. sign the consent formExplain to patients the risks of contrast and answer any questions they have. Check the blood pressure.start Pt. cannulated with IV cannula (18-20 Gag).
- The Pt. is then shift to the CT room .
Patient position : -Supine. -Feet first in gantry. -Hands above the head .- The vertical center is in the middle of the body .- The axial center is in the xiphoid process.
NOTE: we must include the abdomen to avoid repeation & injection of CM twice .
The scanning process :
• Scout Images: PA : plane 180º Lat : plane 90º
- Inject the Pt. with IV contrast omnipaque or xenetix 300 by injector machine.
Flow rate 3ml/sec. volume 120 ml.
By using the smart prep technique , after the CM is seen in the aorta in smart prep image the scan is delay for 65 sec ( portovenous phase ) .
• The serial of procedure :
Type of recons.
DFOV SFOV mA K.V End locat.
Start locat.
Space Thickness
Type of scan
Standard
30 – 50 cm The size of the Pt.
M ,LThe size of the
Pt.
Auto mA 200 - 400
120 Pubic bone
.
Mid of the
chest
5
5 Helical
2nd reconstruction
1.25 ×1.25For reformat only.
- When the scan is end we can have 2D reformats (coronal, sagittal ).
additional procedure :
- The doctor may need • Delayed image after 10 min ( full KUB) to localized the area &
size of the legion .• Rectal contrast 500 ml .
showing a large filling defect (mass) extending posteriorly (arrows).
(C) Coronal CT reformat shows fluid-filled diverticulum (arrow).
(D) Sagittal CT reformat shows a diverticulum descending from the inferior border of the small bowel (arrow).
CT axial images with oral and intravenous contrast. A fluid filled diverticulum .
Patient after care :- The site of contrast injection will be bandaged. - The technologist will continue to watch the patient for possible
adverse contrast reactions.
- Pt. can eat or drink as normal.
- If the Pt. inject with contrast, he/she should drink plenty of liquid to help flush it out from there system.
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