Anatomy of Paranasal Sinus (PNS)

Image taken from Radiology Expert

Appearance of Paranasal Sinuses in CT Scan

Right Adrenal Gland

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

  • 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.

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

  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