CT PROCEDURE REFERENCE GUIDE 2017

Transcription

1 Head CT PROCEDURE REFERENCE GUIDE 2017 Procedure Contrast Scan Field Preparatio n Base of Skull to Vertex Sinuses Orbits Mastoids/IAC/ Temporal Bones Facial Bones ST Neck Low Dose Lung Screening Routine Chest & **CT Sella Turcica- Radiologist prefers MRI** *Exam does not need precertificatio n *Exam free while grant money available Hard Palate thru Frontal Sinus Hard Palate thru Frontal Sinus Detailed cuts thru Mastoid and Temporal Bones Mandible thru Frontal Sinus Mastoids to Aortic Arch Apex thru lung bases Apex thru adrenal glands Revised October /2017 Diagnosis NE HA AMS Seizure Hx R/O Mets NE Sinusitis HA Sinus Drainage/ Pressure Swelling Cellulitis Abscess NE Mastoiditis Hearing Loss Swelling Cellulitis Abscess Lump/Swelling Lymphedema NE Screening *Pt must meet screening criteria* Abnormal CXR

2 Hi Res Chest Chest for PE Cardiac Score **Cannot be done at ODIC** CTA Cardiac Abdomen/Pelvis **Pt will be drinking oral contrast for 1 hr before scan. Pneumonia Cough SOB *$49 due at time of service IV & Apex to Costaphrenic Angles- Lung Markings T1-T11 Pulmonary Arteries Screen for Coronary Artery Calcifications Coronary Arteries thru Pelvic Rami NE COPD Emphysema LIQUID Must Have 20g or Larger caffeine, stimulants, or strenuous exercise after midnight day of service NPO 6 HRS caffeine, stimulants, or strenuous exercise 24 hrs prior, ED meds 4 hrs prior, Excedrin 12 hrs prior SOB Blood Clot DVT Family Hx CAD Hypertension High Cholesterol CAD ABN Stress Test Abd pain Nausea Vomiting Diarrhea R/O Appy Abdomen IV & thru Iliac Upper abd pain Nausea

3 **Pt will be drinking oral contrast for 30 min before scan Dual Pancreas Triphase Kidneys Adrenal Glands *Must be Specified* **If pelvis also, this patient will drink oral contrast for 1 hour prior to scan. Otherwise, the patient doesn t drink oral. Tri-Phase Liver *Must be Specified* **If pelvis also, this patient will drink oral contrast for 1 hour prior to scan. Otherwise, the patient doesn t drink oral Crest Vomiting **Will Not R/O appendicitis, or if patient has pain below iliac crest** & IV & **Routine** & **Only if microspheres, Cirrhosis of Liver, or if a Cancer Patient** Exam is organ specific Special multiphase studies *Must be specified on the order* Exam is organ specific Special multiphase studies *Must be specified on the order* Renal Stone **Must be Abdomen and Pelvis scan** thru Pelvic Rami- Renal Stone NE Flank pain Hematuria Hx of Stones Urogram & Urinary System Special Multi- Phase study Hematuria

4 Extremity Arthrograms **Ask patient to arrive 40 minutes prior to X-ray table time. Myelograms C-Spine T-Spine L-Spine CTA Carotids/Neck CTA Chest **Cannot be done at ODIC** CTA Abd/Pelvis Upper Ext Lower Ext contrast Upper ext Lower ext C-spine w T-spine w L-spine w Specify Right or Left and area of interest Specify Rt or Left and area of interest Cspine- Base of Skull to T1 Tspine-C7-L1 Lspine- T12- Sacrum Base of Skull to T1 Revised October /2017 Pain No prep No driver No NPO See RN Notes for Specifics Pain Radiculopathy NE Pain C7-L1 NE Pain T12-Sacrum NE Pain Aortic arch to Circle of Willis Apices to crux of diaphragm to Pelvic Rami Bruit Stenosis Aneurysm Dissection Aneurysm Dissection

5 CTA Runoff CT Biopsies or Drains to Feet Done per Radiologist in CT (Must be preapproved by Radiologist) PVD Claudication Non-healing ulcer/wound NPO after midnight or 6 hours prior to procedure PT/PTT/Platelets/INR drawn prior Must stop anticoagulant/ antiplatelets 5 days prior Must not drive post procedure **SPECIAL CONSIDERATIONS: When contrast is indicated for the exam, lab creatinine must be checked within 30 days for any patients 65 years of age and above, renal disease, multiple myeloma, diabetic, or taking any Metformin containing medications. Patients with Iodine Allergy must be scheduled at the hospital and be premedicated. Scheduling will fax premedication instructions when the exam is ordered. If IV contrast is indicated patients must be NPO except liquids for 2 hours prior. Patients should be encouraged to be well hydrated since an IV will need to be obtained. This is especially important for CTA s where a larger IV is required. Dialysis patients must receive their dialysis treatment within 24 hours after having an IV contrast injection.