CT THORAX, ABDOMEN AND PELVIS (TAP) WITH CONTRAST

Last Updated on July 24, 2022 by Mohamad Izwan

Anatomy of Thorax, Abdomen and Pelvis

Image taken from Microbe Notes

Appearance of CT Thorax, Abdomen and Pelvis Images

Examination Overview

Protocol Structure

00_TAP_SinglePhase (Adult)

    • Topogram
    • TAP NC

Contrast

    • TAP IV
    • Delayed 5 Minutes (Optional)

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 upper shoulder to start the topogram.

Topogram Parameters

  • Topogram length: 768 mm
  • 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 the topogram image according to organ of interest.
  • Set the top line of Thorax SFOV at the level of shoulder
  • Set the bottom line of Thorax SFOV at the level of above liver dome.
  • Next, set the topline of Abdomen & Pelvis SFOV at the level above liver dome (continue the last point of Thorax scanning).
  • Set the bottom line of Abdomen & Pelvis SFOV at the level of inferior ischial ramus (to also include scrotum if pathologically indicated.
  • Ensure the lateral line to cover patient’s outline soft tissue wall.
  • Remind the patient before scanning as the breathing instruction will be given.
Scan FOVTop LineBottom LineSide-to-side Line
ThoraxLevel of ShoulderAbove DiaphragmLateral Soft Tissue Wall
Abdomen & PelvisAbove DiaphragmInferior Ischial RamusLateral Soft Tissue Wall

Scanning Parameters

  • kV: 100 kV
  • mAs: Tube Current Modulation (TCM)
  • Scanning Direction: Craniocaudal
  • Scan Delay: 4 s
  • Slice: 5.0mm
  • Image Comment: Pre-Contrast
  • Pitch: 0.6
  • Quality Reference mAs : 230

Reconstruction of TAP Non Contrast

Recon 1Recon 2Recon 3Recon 4Recon 5
NameThorax NC 5.0 B30fLung NC 5.0 B70fTAP NC 5.0 B30fTAP NC 1.0 B30fLung NC 1.0 B70f
Slice Thickness5.0 mm5.0 mm5.0 mm1.0 mm1.0 mm
Increment5.0 mm5.0 mm5.0 mm0.7 mm0.7 mm
KernelB31f medium smoothB70f Very SharpB30f Medium SmoothB30f Medium SmoothB70f Very Sharp
WindowingMediastinumLungAbdomenAbdomenLung

Contrast Injection Setup

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 (normal body type)
      • 120 – 150 ml (large body type)
    • Volume of Normal Saline: 50 ml
    • Method of injection: Contrast Injector Dual Phase

Injector setup for Normal Body Size

Contrast AContrast BNormal Saline
Flow rate3.5 ml/sec2.5 ml/sec3.0 ml/sec
Injection Volume80 ml20 ml50 ml

Injector setup for Large Body Size

Contrast AContrast BNormal Saline
Flow rate3.5 ml/sec2.5 ml/sec3.0 ml/sec
Injection Volume100 - 130 ml20 ml50 ml

Post Contrast Scan Planning

TAP IV

  • Plan the Scan FOV (SFOV) box at topogram image. Follow the TAP NC scanning setup.
  • Scanning Delay: 60 seconds
    • (to get Late Arterial Phase of Thorax and Portal Venous Phase of Abdomen and Pelvis).

Reconstruction of TAP IV

Recon 1Recon 2Recon 3Recon 4
NameThorax IV 5.0 B31fLung IV 5.0 B70fTAP IV 5.0 B30fTAP IV 1.0 B30f
Slice Thickness5.0 mm5.0 mm5.0 mm1.0 mm
Increment5.0 mm5.0 mm5.0 mm0.7 mm
KernelB31f medium smoothB70f Very SharpB30f Medium SmoothB30f Medium Smooth
WindowingMediastinumLungAbdomenAbdomen

Delayed 5 Minutes (Optional)

  • Full abdomen
    • 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 ischial rami.
    • Remind the patient before scanning as the breathing instruction will be given.

  • Urinary Bladder
    • Plan the Scan FOV (SFOV) box at topogram image
    • Set the top line at the level of half of ilium (depend on location of pathology).
    • Set the bottom line at the level of ischial rami.
    • Ensure the lateral line to cover patient’s body outline.

Reconstruction of Delayed

Recon 1Recon 2
NameDELAY 5.0 B30fDelay 1.0 B20f
Slice Thickness5.0 mm1.0 mm
Increment5.0 mm0.7 mm
KernelB30f Medium SmoothB20f Smooth
WindowingAbdomenAbdomen

Criteria of Good CT TAP Image

This is the axial cut of CT TAP at the level of mediastinum. The contrast enhancement shown great contrast during late arterial phase.
Contrast enhancement in late arterial phase
The axial cut image of CT TAP at the level of liver. The image shown the portal vein is in-phase of contrast enhancement.
Portal vein in-phase enhancement

Post Processing Image

– none

Series of Images Send to PACS

  1. Topogram
  2. Thorax NC 5.0 B30f
  3. Lung NC 5.0 B70f
  4. TAP NC 5.0 B30f
  5. TAP NC 1.0 B30f
  6. Lung NC 1.0 B70f
  7. Thorax IV 5.0 B31f
  8. Lung IV 5.0 B70f
  9. TAP IV 5.0 B30f
  10. TAP IV 1.0 B30f
  11. Delay 5 Min 5.0 B30f
  12. Delay 5 Min 1.0 B20f
  13. Patient Protocol

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