MSK CT PROTOCOL[2] - jefferson.edu · AC joint. SHOULDER Coronal Imaging Plane Coronal Imaging...
Transcript of MSK CT PROTOCOL[2] - jefferson.edu · AC joint. SHOULDER Coronal Imaging Plane Coronal Imaging...
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UPPER EXTREMITY
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SHOULDER
PositioningPatient supineAffected arm by side of bodyContralateral arm raised above head.
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SHOULDER
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SHOULDER
-Axial-Coronal -Sagittal
22Reformat
-Bone-Soft Tissue
0.621.25Reconstruct
Type/PlaneInterval (mm)Slice (mm)
200140Large0
mAKVFOVGantry Tilt
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SHOULDERScanning Plane
•Prescribe plane parallel to humeral shaft. •Cover from AC joint through proximal humeral diaphysis.
Relevant Anatomy
ClavicleAcromium
Humeral Head
AC joint
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SHOULDERCoronal Imaging Plane
Coronal Imaging Plane•Prescribe coronal plane off of axial images parallel
to supraspinatus muscle
Relevant Anatomy
SupraspinatusInfraspinatus
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SHOULDERSagittal Imaging Plane
Humeral Head
Bony Glenoid
Relevant Anatomy Sagittal Imaging Plane•Prescribe sagittal plane off axial images with
line parallel to bony glenoid. •Image from scapular wing through deltoid muscle.
Deltoid Muscle
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ELBOW
PositioningPatient supineArm by side or raised above headPalm up
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ELBOW
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ELBOW
-Axial-Coronal -Sagittal
1.50.8Reformat
-Bone-Soft Tissue
0.30.625Reconstruct
Type/PlaneInterval (mm)Slice (mm)
150120Small0
mAKVFOVGantry Tilt
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ElbowScanning Plane
•Prescribe plane perpendicular to coronal plane (©).
•Scan from humeral diaphysis past radial tuberosity
Relevant Anatomy
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ELBOWCoronal Imaging Plane
Relevant AnatomyCoronal Imaging Plane
*Prescribe plane parallel to anterior humerus at condyles. Scan through entire elbow.
*
*
Lateral Humeral Condyle
Medial Humeral Condyle
Olecranon processof Ulna
Humerus
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ELBOWSagittal Imaging Plane
Sagittal Imaging Plane*Prescribe plane perpendicular to coronal plane (©). Scan
through entire elbow.
©
©
*
*Lateral Humeral Condyle
Medial Humeral Condyle
Olecranon processof Ulna
Humerus
Relevant Anatomy
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WRIST
PositioningPatient proneArm over head (“Mighty Mouse Position”)Arm as straight as possibleWrist centered in gantry
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WRIST
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WRIST
-Axial-Coronal -Sagittal
1.50.8Reformat
-Bone-Soft Tissue
0.30.625Reconstruct
Type/PlaneInterval (mm)Slice (mm)
150120Small0
mAKVFOVGantry Tilt
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WRISTScanning Plane
•. Prescribe plane parallel to distal radius. •Scan from proximal metacarpals through distal
radial/ulnar metaphysis.
Relevant Anatomy
cap
triqscaph
ham
lun
trapm
Distradius
Distalulna
metacarpalstrapz
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WRISTCoronal Imaging Plane
Relevant Anatomy Coronal Imaging Plane•Prescribe plane parallel to line drawn from
ulnar styloid through radial styloid. •Scan through entire wrist.
UlnarStyloid
RadialStyloid
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WRISTSagittal Imaging Plane
Relevant Anatomy
UlnarStyloid
RadialStyloid
Sagittal Imaging Plane*Prescribe plane perpendicular to coronal plane (©).
Scan through entire wrist.
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WRISTSagittal Imaging Plane
UlnarStyloid
RadialStyloid
Relevant AnatomySagittal Imaging Plane
*Prescribe plane perpendicular to coronal plane (©).Scan through entire wrist.
©
©
**
UlnarStyloid
RadialStyloid
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LOWER EXTREMITY
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HIP
PositioningPatient SupineLegs flat on table
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HIPS
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HIP
-Axial-Coronal -Sagittal
22Reformat
-Bone-Soft Tissue
0.621.25Reconstruct
Type/PlaneInterval (mm)Slice (mm)
200140Large0
mAKVFOVGantry Tilt
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HIPScanning Plane
•Prescribe plane parallel to acetabular roof•Scan from acetabular roof through lesser trochanter
Relevant Anatomy
GreaterTrochanter
AcetabularRoof
LesserTrochanter
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HIPCoronal Imaging Plane
Greater Trochanter
FemoralNeck
Superior Pubic Ramus
Relevant AnatomyCoronal Imaging Plane
*Prescribe plane parallel femoral heads. Scan from ischium through pubic
symphesis.
Ischium
*
FemoralHead
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HIPSagittal Imaging Plane
Greater Trochanter
FemoralNeck
Superior Pubic Ramus
Femoral Head
Ischium
Relevant AnatomySagittal Imaging Plane
*Prescribe plane perpendicular to coronal plane. Scan from acetabulum through greater
trochanter.
*
*
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KNEE
Positioning:Patient Supine with feet first into scannerKeeps knees extended, side-by-side.Tape the feet together with toes pointing up to help keep the knees from moving.Slide patient so that the knee being scanned is in the center of the table
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KNEE
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KNEE
-Axial-Coronal -Sagittal
1.50.8Reformat
-Bone-Soft Tissue
0.50.625Reconstruct
Type/PlaneInterval (mm)Slice (mm)
150120Small0
mAKVFOVGantry Tilt
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KNEE
Relevant AnatomyScanning Plane
• Prescribe plane parallel to axis of the tibial plateau.• Scan knee from suprapatellar region to the proximal tibia
Tibia
Femur
Plateau
Patella
Suprapatellar
Region
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KNEECoronal Imaging
Relevant Anatomy
MedFemCondyle
LatFemCondyle
Patella
Coronal Imaging PlanePrescribe plane with line parallel to
femoral condyles. Image entire knee.
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KNEESagittal Imaging Plane
MedFemCondyle
LatFemCondyle
Patella
Relevant AnatomySagittal Imaging Plane
*Prescribe plane perpendicular to coronal plane (©).Scan from the medial to the lateral femoral condyle.
©©
*
*
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ANKLE
Positioning:Patient supineCenter in scanner both feet or foot of interest (use foot holder, if available). If imaging both feet, bring them togetherToes pointing straight up.Foot inverted slightly
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ANKLE
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-Axial-Coronal -Sagittal
1.50.8Reformat
-Bone-Soft Tissue
0.30.625Reconstruct
Type/PlaneInterval (mm)Slice (mm)
150120Small0
mAKVFOVGantry Tilt
ANKLE
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ANKLE
Relevant Anatomy
Scanning Plane•Prescribe plane parallel to axis of calcaneus.•Scan ankle from distal tibia through beyond
the inferior calcaneous
Tibia
Talus
Calcaneous
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ANKLECoronal Imaging Plane
Coronal Imaging PlanePrescribe plane perpendicular
to axial imaging plane. Scan ankle from calcaneus through metatarsal bases.
Calcaneus
Talus
Cuboid
METATARSALS
Relevant Anatomy
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ANKLESagittal Imaging Plane
Sagittal Imaging PlanePrescribe plane with line bisecting
calcaneus. Scan through entire foot.Relevant Anatomy
Calc
aneu
s
Cuboid
Late
ral
Cune
iform
Med
ial
Cun
eifo
rm
Inte
rmed
iate
Cune
iform