Anatomy of Paranasal Sinus (PNS)
![](https://askradiographer.com/database/Anatomy-of-Paranasal-Sinuses.png)
Image taken from Radiology Expert
Appearance of Paranasal Sinuses in CT Scan
![](https://askradiographer.com/database/Right-Adrenal-Gland-in-Axial-CT.jpg)
Right Adrenal Gland
![](https://askradiographer.com/database/Left-Adrenal-Gland-in-Axial-CT.jpg)
Left Adrenal Gland
Examination Overview
Protocol Structure
00_Sinus (Adult)
- Topogram
- Sinus
- Contrast
- Sinus IV
Topogram
- Position the patient in head first supine position.
- Place the patient’s head in designated head rest.
- Align the patient’s head in Mid-Sagittal plane of the table.
- Position the transverse laser light beam at the level of patient’s vertex of skull to start the head topogram.
Patient Orientation Registry in System
![](https://askradiographer.com/database/Patient-Position-Registry.png)
- Set the orientation patient in system: Head First – Supine
Topogram Parameters
- Topogram length: 256 cm
- Slice: 0.6 mm
- Scanning direction: Craniocoudal
- Tube position: Lateral
- Stop the topogram scanning when the scanning reach / pass over the hard palate / teeth.
Non Contrast
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level above frontal sinus.
- Set the bottom line at the level below hard palate / teeth.
- Ensure the anterior and posterior lines to cover patient’s facial and occipital bones.
- Remind the patient before scanning as to keep still during scanning.
- Angulation of SFOV may be needed to ensure parallel of hard palate.
![](https://askradiographer.com/database/Topogram-Delay-Full-Abdomen.jpg)
Scanning Parameters
- kVp:
- mAs: Tube Current Modulation (TCM)
- Scanning Direction: Craniocaudal
- Scan Delay: 4 s
- Slice:0.6
- Image Comment: Non Contrast
- Pitch: 0.6
Reconstruction of Non Contrast
Contrast
Type of contrast used:
- Non-ionic iodinated contrast media
- 300 I mg/mol
Contrast Injection:
- Volume of Contrast Media: 50 ml
- Volume of Normal Saline: 20 ml
- Method of injection: Hand Bolus
Post Contrast Scan Planning
Sinus IV
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level above frontal sinus.
- Set the bottom line at the level below hard palate / teeth.
- Ensure the anterior and posterior lines to cover patient’s facial and occipital bones.
- Remind the patient before scanning as to keep still during scanning.
- Angulation of SFOV may be needed to ensure parallel of hard palate.
Reconstruction of Sinus IV
Multiplanar Reconstruction (MPR)
Coronal Portal Venous Phase
- Image Thickness: 3.0 mm
- Number of Image: 19
- Coverage: Anterior to Posterior of abdomen
Series of Images Send to PACS
- Topogram
- Non Contrast 5.0 B30f
- Non Contrast 1.0 B20f
- PVP 5.0 B30f
- PVP 1.0 B20f
- Delayed 15 Min 5.0 B30f
- Delayed 15 Min 1.0 B20f
- Patient Protocol
- COR ST PVP