Last Updated on January 20, 2023 by Mohamad Izwan
Anatomy of Thorax
Image taken from Britannica
Appearance of CT Thorax Images
Examination Overview
Protocol Structure
00_ThoraxRoutine (Adult)
-
- Topogram
- Non Contrast (upper shoulder to iliac crest)
Contrast
-
- Portal Venous Phase
- (upper shoulder to the iliac crest)
- (upper shoulder to the iliac crest)
- Portal Venous Phase
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: 512 mm
- Slice: 0.6 mm
- Scanning direction: Craniocoudal
- Tube position: Top
- Stop the topogram scanning when the scanning reach / pass over the iliac crest.
Non Contrast
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level of upper shoulder
- Set the bottom line at the level of iliac crest.
- Ensure the lateral line to cover patient’s body outline.
- Remind the patient before scanning as the breathing instruction will be given.
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: 1.2
- Quality Reference mAs : 230
Reconstruction of Thorax Non Contrast
| Recon 1 | Recon 2 | Recon 3 | |
|---|---|---|---|
| Name | Thorax NC 5.0 B31f | Thorax NC 5.0 B80f | Thorax NC 1.0 B70f |
| Slice Thickness | 5.0 mm | 5.0 mm | 1.0 mm |
| Increment | 5.0 mm | 5.0 mm | 0.7 mm |
| Kernel | B31f medium smooth | B80f ultra sharp | B70f very sharp |
| Windowing | Mediastinum | Lung | Lung |
Contrast
Type of contrast used:
-
- Non-ionic iodinated contrast media
- 300 I mg/mol
Needle Placement Test:
-
- Flow Rate: 4.5 ml/sec
- Volume of Normal Saline: 20 ml
Contrast Injection:
-
- Volume of Contrast Media:
- 70 ml (normal body type)
- 90 ml (large body type)
- Volume of Normal Saline: 50 ml
- Method of injection: Contrast Injector Single Phase
- Volume of Contrast Media:
Injector setup for Normal Body Size
| Contrast A | Normal Saline | |
|---|---|---|
| Flow rate | 3.0 ml/sec | 3.0 ml/sec |
| Contrast Volume | 70 ml | 50 ml |
Injector setup for Large Body Size
| Contrast A | Normal Saline | |
|---|---|---|
| Flow rate | 3.0 ml/sec | 3.0 ml/sec |
| Contrast Volume | 90-110 ml | 50 ml |
Post Contrast Scan Planning
Thorax IV
- Plan the Scan FOV (SFOV) box at topogram image.
- Set the top line at the level upper shoulder.
- Set the bottom line at the level of iliac crest.
- Ensure the lateral line to cover patient’s body outline.
- Remind the patient before scanning as the breathing instruction will be given.
- Delay: 35 seconds.
Reconstruction of TAP IV
| Recon 1 | Recon 2 | Recon 3 | Recon 4 | |
|---|---|---|---|---|
| Name | Thorax IV 5.0 B31f | Thorax IV 5.0 B80f | Thorax IV 1.0 B31f | Thorax IV 1.0 B70f |
| Slice Thickness | 5.0 mm | 5.0 mm | 1.0 mm | 1.0 mm |
| Increment | 5.0 mm | 5.0 mm | 0.7 mm | 0.7 mm |
| Kernel | B31f medium smooth | B80f ultra sharp | B31f Medium Smooth | B70f very sharp |
| Windowing | Mediastinum | Lung | Mediastinum | Lung |
Series of Images Send to PACS
- Topogram 0.6 T20f
- Thorax NC 5.0 B31f
- Thorax NC 5.0 B80f
- Thorax NC 1.0 B70f
- Thorax IV 5.0 B31f
- Thorax IV 5.0 B80f
- Thorax IV 1.0 B31f
- Thorax IV 1.0 B70f
- Patient Protocol
