Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology...
-
Upload
rory-tinkham -
Category
Documents
-
view
247 -
download
2
Transcript of Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology...
![Page 1: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/1.jpg)
Pelvic CT scan
Done by:Alia BafqeehNora Alohaly
![Page 2: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/2.jpg)
Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care .
Outlines :
![Page 3: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/3.jpg)
It is an imaging method that uses x-rays to create cross-sectional pictures of the organs inside the pelvis (bladder, prostate, lymph nodes and pelvic bones).
CT scan of the pelvis:
![Page 4: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/4.jpg)
Pelvic truma or fracture . Hematuria or suspected renal calculus.Hematoma. Suspected hemorrhage. Hip osteonecrosis. Ischemic bowel.Pelvic inflammatory or infection disease(abscess/colitis).Pelvic vein thrombosis. Congenital abnormalities e.g. CHD. Tumors, suspected or known (Lymphadenopathy/Primary or
metastatic malignancies)
Indications of pelvic CT :
CHD Ewing sarcoma osteosarcoma of the ilium
![Page 5: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/5.jpg)
There are no absolute contraindications to pelvic CT examinations, the relative benefits should be outweigh the exposure risk.
• Check the following conditions : – ALLERGIES, ASTHMA, DIABETIES, KIDNEY DISEASE
• Ask if a patient is PREGNANT. • Ask about prior reaction to contrast.
Contraindications of pelvic CT :
![Page 6: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/6.jpg)
Pelvic CT scan :
In KKUh there are 2 protocols
Truma . Pathology .
![Page 7: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/7.jpg)
Truma protocol (C-)
E.g. to rule out fractures or history of truma .
Patient preparation :
No need for pt. preparation since he comes directly from the ER .
- Pt. should be stable (vital sings).
- On stretcher.- No need to be NPO except if a sedation is needed ( NPO for 3-4
hrs).
Patient position :
-Supine.
-Feet first in gantry.
-Hands above the head .
![Page 8: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/8.jpg)
- The vertical center is in the middle of the pelvis .
- The axial center is in the iliac crest.
The scanning process :• Scout Images: PA : plane 180º Lat : plane 90º
![Page 9: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/9.jpg)
Type of recons .
DFOV SFOV mA K.V End locat.
Start locat.
Space Thickness Type of scan
Standard 30 – 50 cm
The size of the Pt.
M ,LThe size of the
Pt.
Auto mA 200 - 400
120 Mid of thigh.
L4 2.5
5 Helical
Standard window Bone window
• The serial of procedure :
2nd reconstruction
Bone window
fractures.
![Page 10: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/10.jpg)
- When the scan is end we can have 2D reformats (coronal, sagittal ) and 3D pelvis .
![Page 11: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/11.jpg)
pathology protocol (C+) E.g. Ca ovarian , mass or swelling
Patient preparation :
- 60 ml castor oil the night before the procedure. - NPO from mid night . - The patient should be in department 2hrs before start the procedure. - check that pt. not allergic or asthmatic . - Check pt. renal function test ; for inpatient 1 week outpatient (diabetic) 3 months outpatient (non-diabetic) 6 months
- Pt. is given the oral contrast gastrografin or telebrix 3% (30 ml in 1000 ml of water ), one cup every 10 min .
![Page 12: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/12.jpg)
- After 1hr Pt. call and stay in beside room:
Pt. sign the consent formExplain to patients the risks of contrast and answer any questions they have. Check the blood pressure.start Pt. cannulated with IV cannula (18-20 Gag).
- The Pt. is then shift to the CT room .
Patient position : -Supine. -Feet first in gantry. -Hands above the head .- The vertical center is in the middle of the body .- The axial center is in the xiphoid process.
NOTE: we must include the abdomen to avoid repeation & injection of CM twice .
![Page 13: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/13.jpg)
The scanning process :
• Scout Images: PA : plane 180º Lat : plane 90º
- Inject the Pt. with IV contrast omnipaque or xenetix 300 by injector machine.
Flow rate 3ml/sec. volume 120 ml.
By using the smart prep technique , after the CM is seen in the aorta in smart prep image the scan is delay for 65 sec ( portovenous phase ) .
![Page 14: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/14.jpg)
• The serial of procedure :
Type of recons.
DFOV SFOV mA K.V End locat.
Start locat.
Space Thickness
Type of scan
Standard
30 – 50 cm The size of the Pt.
M ,LThe size of the
Pt.
Auto mA 200 - 400
120 Pubic bone
.
Mid of the
chest
5
5 Helical
2nd reconstruction
1.25 ×1.25For reformat only.
![Page 15: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/15.jpg)
- When the scan is end we can have 2D reformats (coronal, sagittal ).
![Page 16: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/16.jpg)
additional procedure :
- The doctor may need • Delayed image after 10 min ( full KUB) to localized the area &
size of the legion .• Rectal contrast 500 ml .
showing a large filling defect (mass) extending posteriorly (arrows).
![Page 17: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/17.jpg)
(C) Coronal CT reformat shows fluid-filled diverticulum (arrow).
(D) Sagittal CT reformat shows a diverticulum descending from the inferior border of the small bowel (arrow).
CT axial images with oral and intravenous contrast. A fluid filled diverticulum .
![Page 18: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/18.jpg)
Patient after care :
- The site of contrast injection will be bandaged. - The technologist will continue to watch the patient for possible
adverse contrast reactions.
- Pt. can eat or drink as normal.
- If the Pt. inject with contrast, he/she should drink plenty of liquid to help flush it out from there system.
![Page 19: Pelvic CT. Indications. Contraindications. Pelvic CT protocols. - Truma protocol. - Pathology protocol. Patient after care.](https://reader035.fdocuments.in/reader035/viewer/2022062404/551b606c550346a6148b46cf/html5/thumbnails/19.jpg)