CT BRAIN CONTRAST (IGS PROTOCOL)

Last Updated on June 25, 2022 by Mohamad Izwan

Anatomy of Thorax, Abdomen and Pelvis

Image taken from Microbe Notes

Appearance of CT Brain IGS Protocol

Examination Overview

Protocol Structure

00_Head_IGS (Adult)

    • Topogram
    • Head NC (skull vertex to the base of skull)

Contrast

    • Head IV (skull vertex to the base of skull)

Topogram

  • Position the patient in head first supine position.
  • Position the patient’s head inside the head rest with proper positioning to avoid rotation and tilting.
  • Align the patient in Mid-Sagittal plane of the table.
  • Position the transverse laser light beam at the top of the patient’s head to start the topogram.

Topogram Parameters

  • Topogram length: 256 mm
  • Slice: 0.6 mm
  • Scanning direction: Craniocoudal
  • Tube position: Lateral
  • Stop the topogram scanning when the scanning reach / pass over the base of skull.

Head NC

  • Plan the Scan FOV (SFOV) box at topogram image
  • Set the top line at the top of vertex.
  • Set the bottom line at the level of base of skull.
  • Ensure the lateral line to cover patient’s head outline.
  • Ensure that there is no CT machine gantry angulation (0° tilt) during scanning

Scanning Parameters

  • kV: 100 kV
  • mAs: Tube Current Modulation (TCM)
  • Scanning Direction: Craniocaudal
  • Scan Delay: 4 s
  • Slice: 1.0mm
  • Image Comment: Pre-Contrast
  • Pitch: 0.6
  • Quality Reference mAs : 230

Reconstruction of Head NC

Recon 1Recon 2
NameHead NC 1.0 H31s for IGSHead NC 1.0 H31s for MPR
Slice Thickness1.0 mm1.0 mm
Increment1.0 mm0.8 mm
KernelH31s medium smoothH31s medium smooth
WindowingBase OrbitaBase Orbita

Contrast

Type of contrast used:

    • Non-ionic iodinated contrast media
    • 300 I mg/mol
  •  Contrast Injection:
    • Volume of Contrast Media: 50 ml
    • Method of injection: Hand bolus injection

Post Contrast Scan Planning

Head IV

  • Plan the Scan FOV (SFOV) box at topogram image
  • Set the top line at the top of vertex.
  • Set the bottom line at the level of base of skull.
  • Ensure the lateral line to cover patient’s head outline.
  • Immediate scan after administration of contrast media through IV line.

Reconstruction of Head IV

Recon 1Recon 2
NameHead IV 1.0 H31s for IGSHead IV 1.0 H31s for MPR
Slice Thickness1.0 mm1.0 mm
Increment1.0 mm0.8 mm
KernelH31s medium smoothH31s medium smooth
WindowingBase OrbitaBase Orbita

Multiplanar Reconstruction (MPR)

 

  • If the reconstruction already symmetrical, no need to do another axial plane.

Series of Images Send to PACS

  1. Topogram 0.6 T20f
  2. Head NC 1.0 H31s for IGS
  3. Head NC 1.0 H31s for MPR
  4. Head IV 1.0 H31s for IGS
  5. Head IV 1.0 H31s for MPR
  6. Patient protocol

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