CT ADRENAL 3 PHASE

Anatomy of Adrenal Gland

Image taken from Microbe Notes

Appearance of Adrenal Gland in Axial CT Image

Right Adrenal Gland

Left Adrenal Gland

Examination Overview

Protocol Structure

00_Adrenal3Phase (Adult)

  • Topogram
  • Non Contrast (above diaphragm to ischial rami)

Contrast

  • Portal Venous Phase
    • (above diaphragm to ischial rami)
  • Delayed 15 Minutes
    • (above diaphragm to ischial rami)

Topogram

  • Position the patient in head first supine position.
  • Align the patient in Mid-Sagittal plane of the table.
  • Position the transverse laser light beam at the level of patient’s nipple line to start the abdominal topogram.

Topogram Parameters

  • Topogram length: 512 cm
  • Slice: 0.6 mm
  • Scanning direction: Craniocoudal
  • Tube position: Top
  • Stop the topogram scanning when the scanning reach / pass over the inferior ischial ramus.

Non Contrast

  • Plan the Scan FOV (SFOV) box at topogram image
  • Set the top line at the level of mid heart
  • Set the bottom line at the level of inferior ischial ramus.
  • Ensure the lateral line to cover patient’s body outline.
  • Remind the patient before scanning as the breathing instruction will be given.

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

Recon 1Recon 2
NameNon Contrast 5.0 B30fNon Contrast 1.0 B20f
Slice Thickness5.0 mm1.0 mm
Increment5.0 mm0.7 mm
KernelB30f medium smoothB20f smooth
WindowingAbdomenAbdomen

Contrast

Type of contrast used:

  • Non-ionic iodinated contrast media
  • 300 I mg/mol

Needle Placement Test:

  • Flow Rate: 3.5 ml/sec
  • Volume of Normal Saline: 15 ml

Contrast Injection:

  • Volume of Contrast Media: 100 ml (depend on patient’s body habitus)
  • Volume of Normal Saline: 50 ml
  • Method of injection: Contrast Injector
  • Flow Rate:
    • Contrast: 3.0 ml/sec
    • Normal Saline: 3.0 ml/sec

Post Contrast Scan Planning

Venous Phase

  • Plan the Scan FOV (SFOV) box at topogram image.
  • Set the top line at the level above the diaphragm.
  • Set the bottom line at the level of inferior ischial rami.
  • Ensure the lateral line to cover patient’s body outline.
  • Remind the patient before scanning as the breathing instruction will be given.
  • Scan delay after contrast injection: 65 sec.

Reconstruction of Venous Phase

Recon 1Recon 2
NameVenous Phase 5.0 B30fVenous Phase 1.0 B20f
Slice Thickness5.0 mm1.0 mm
Increment5.0 mm0.7 mm
KernelB30f medium smoothB20f smooth
WindowingAbdomenAbdomen

Delayed 15 Minutes

  • Plan the Scan FOV (SFOV) box at topogram image
  • Set the top line at the level of above diaphragm.
  • Set the bottom line at the level of inferior ischial rami.
  • Ensure the lateral line to cover patient’s body outline.
  • Remind the patient before scanning as the breathing instruction will be given.

Reconstruction of Delayed

Recon 1Recon 2
NameDelayed15 Min 5.0 B30fDelayed 15 Min 1.0 B20f
Slice Thickness5.0 mm1.0 mm
Increment5.0 mm0.7 mm
KernelB30f medium smoothB20f smooth
WindowingAbdomenAbdomen

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

  1. Topogram
  2. Non Contrast 5.0 B30f
  3. Non Contrast 1.0 B20f
  4. PVP 5.0 B30f
  5. PVP 1.0 B20f
  6. Delayed 15 Min 5.0 B30f
  7. Delayed 15 Min 1.0 B20f
  8. Patient Protocol
  9. COR ST PVP

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