Anatomy of Wrist

Image taken from sportsinjuryclinic.net

Appearance of Wrist in Axial CT Image

CT Wrist (Axial Images)

Examination Overview

Protocol Structure

00_Extremity (Adult)

  • Topogram
  • Extremity (Non Contrast)

Patient Orientation Registry in System

  • Set the orientation patient in system : Feet First – Prone
  • This is to follow the orientation of wrist (base on anatomical position)

Topogram

  • Position the patient in head first prone position.
  • Raise the patient’s arm above head in pronation position.
  • Align the patient’s wrist in Mid-Sagittal plane of the table (if possible).
  • Position the transverse laser light beam at the level of patient’s finger to start the wrist topogram.

Topogram Parameters

  • Topogram length: 256 cm
  • Slice: 0.6 mm
  • Scanning direction: Caudocranial
  • Tube position: Top
  • Stop the topogram scanning when the scanning reach / pass over the elbow joint.

Non Contrast

  • Plan the Scan FOV (SFOV) box at topogram image
  • Set the top line at the level of mid metacarpals
  • Set the bottom line at the level of distal forearm (distal radius ulna).
  • Ensure the lateral line to cover wrist soft tissue outline.
  • Remind the patient to keep in place and not moving the arm.

Scanning Parameters

  • kVp: 120
  • mAs: Tube Current Modulation (TCM)
  • Scanning Direction: Craniocaudal
  • Scan Delay: 2 s
  • Slice: 3.0mm (Acq. 128 x 0.6 mm)
  • Image Comment: Non Contrast
  • Pitch: 0.8

Reconstruction of Non Contrast

Recon 1Recon 2Recon 3
NameExtremity 3.0 B60sExtremity 1.0 B60sExtremity 1.0 B30s medium smooth
Slice Thickness3.0 mm1.0 mm1.0 mm
Increment3.0 mm0.7 mm0.7 mm
KernelB60s sharpB60s sharpB30s medium smooth
WindowingExtremityBoneAbdomen

Series of Images Send to SyngoVia

  1. Extremity 1.0 B30s

Series of Images Send From SyngoVia to PACS

  1. Radial ranges of wrist

Series of Images Send to PACS

  1. Topogram
  2. Extremity 3.0 B60s
  3. Extremity 1.0 B60s
  4. Extremity 1.0 B30s