CT Triple Phase Abdomen - bartsradiology



CT Triple Phase Abdomen

(Conns Syndrome, Pancreas)

Indications

• Lesion seen on U/S

• ? Pancreatitis

• ? Neoplasm

• ? Conns

Preparation

• 4 hour fast

• 800mls Water prior to scan

• Pink (20Ga) cannula

• For Pancreas 20mg of Buscopan may be given

Technique

• Protocol – Triple Phase Abdomen

• Position – Feet first (supine), Arms up

• Zero – Xiphisternum

Coverage

• Pre contrast – Limit to area of interest

• Arterial Phase – Organ of interest

• Porto Venous Phase – Diaphragm to Iliac Crest

• 10 Min Delayed – through adrenals if required (Conns)

Scan

• Pre contrast through organ of interest

• Pre monitoring slice at the dome of diaphragm

• ROI on abdominal aorta and “Accept”

• 100mls@4mls/sec

• Monitoring – 8sec delay then scans every 2 sec.

• Scan starts automatically when 100HU reached. The scan can be started manually at any point

Recon jobs

Pre contrast

1. 5mm/ 5mm soft tissue axial

2. 1.5mm/ 1.2mm soft tissue axial

Arterial

1. 5mm/ 5mm soft tissue axial

2. 1.5mm/ 1.2mm soft tissue axial

3. 2mm/ 2mm soft tissue coronal

4. 10mm/ 5mm Coronal MIP

Porto Venous

1. 5mm/ 5mm soft tissue axial

2. 1.5mm/ 1.2mm soft tissue axial

3. 2mm/ 2mm soft tissue coronal

4. 1mm Lung axial

Additional Techniques

Conns Syndrome

• If a nodule is present, do 10min delay through the adrenal only

Triple Phase Abdomen + Chest, Abdo, Pelvis

• Protocol – Triple_Phase_ CAP

• Pre contrast abdomen

• Monitoring at diaphragm – triggers at 80HU

• Arterial Phase – Lung Apices to below organ of interest.

• Porto Venous at 65secs post contrast thru’ Abdomen and Pelvis

• 10min delay – adrenals (Conns)

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