CT PULMONARY ARTERIES

Last Updated on February 15, 2022 by Mohamad Izwan

Author: Aqil Jauhar


Protocol Structure

Embolism TestBolus

  • Topogram
  • Control Scan
  • Contrast
  • Test Bolus
  • Embolism

Topogram

Include upper thorax until middle of liver


Control Scan

Put the line at lower of carina(to make a letter ‘A’)  
Ensure cross-sectional of right pulmonary artery appear.


Contrast

Non- Ionic Iodinated Contrast Media 300 mg I/ml Solution for injection/infusion


Injector Setting

Test Bolus

Contrast
Flow rate: 5.0 ml/s
Volume: 15 ml

Normal saline

Flow rate: 5.0 ml/s
Volume: 10 ml

Pulmonary Arteries

Contrast
Flow rate: 4.5/5.0 ml/sec
Volume: 70 ml
(30 ml of contrast + 40 ml of contrast mix with normal saline)

Normal salineFlow rate: 4.5 ml/sec
Volume: 50m ml


Test Bolus

Put the line at lower of carina(to make a letter ‘A’)  
(Put the line same with control scan).

Set the injector for test bolus. When ready, start scan.

Stop scan when the contrast already enhance and flush out from the pulmonary trunk.

DynaEva

Open DynaEva use test bolus image.

Delay from start of injection = 2.0s (take no. of delay at test bolus)

Using Elliptical ROI, make circle at the pulmonary trunk.

Take value of ‘time to peak’ and put at delay embolism. (Normally good peak time 6s to 10 s)


Embolism

Routine section
Delay = take value ‘time to peak’ at dynaEva

Scan from upper thorax until middle of liver.


Reconstruction Post Contrast

 Recon 1Recon 2Recon 3Recon 4 Recon 5
NameMediastinum 3.0 B30fLung 3.0 B70fEmbolism 1.0 B30f
Mediastinal 1.0 B30fLung 1.0 B70f
Slice Thickness3.0mm3.0mm1.0mm1.0mm1.0mm
Increment3.0mm3.0mm0.5mm0.5mm1.0mm
KernelB30f medium smoothB70f very sharpB30f medium smoothB30f medium smoothB70f very sharp
WindowingMediastinumLungCT AngioMediastinumLung

Multi Planar Reconstruction (MPR)

Parallel Ranges:

  • Image thickness : 3.0mm
  • Number of images : 9

IV Mediastinum

  • Coronal thorax
  • Coronal right oblique of pulmonary trunk
  • Coronal left oblique of pulmonary trunk

Siemens SyngoVia 3D Render

Open with ‘CT Vascular’

Punch 

Series of Images Send to PACS

  1. Topogram 0.6 T20f
  2. Mediastinum 3.0 B30f
  3. Lung 3.0 B70f
  4. Embolism 1.0 B30f
  5. Mediastinal 1.0 B30f
  6. Lung 1.0 B70f
  7. Patient protocol
  8. COR THOR
  9. RT COR OBL
  10. LT CORONAL OBL
  11. VRT CTPA

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