Protocols for Multislice CT: 4- and 16-row Applications

143 Pages·2003·3.984 MB·English

by  Roland Bruening, Thomas Flohr (auth.)

Protocols for Multislice CT
4- and 16-row Applications
Roland Bruening
Thomas Flohr
R.Bruening · T.Flohr
Protocols for Multislice CT
4- and 16-row Applications
Springer-Verlag Berlin Heidelberg GmbH
R.Bruening · T.Flohr
Protocols
for Multislice CT
4- and 16-row Applications
With 195 Figures
123
Roland Bruening Thomas Flohr
Neuroradiology Siemens Medical Solutions
Department ofClinical Radiology CT Division
University ofMunich – Grosshadern Siemensstr.1
Marchioninistr.15 91301 Forchheim
81377 Munich Germany
Germany
ISBN 978-3-540-40584-9 ISBN 978-3-662-05142-9 (eBook)
DOI 10.1007/978-3-662-05142-9
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Preface
The radiology community has seen a substantial technical innovation with the development
ofmultislice computed tomography (CT).The introduction ofmultiple parallel detectors is
undoubtedly one ofthe most important technical improvements in the field ofCT.More-
over,the new advantages ofCT may also have an impact on the general use ofCT and mag-
netic resonance imaging (MRI).
Multislice CT is becoming increasingly available in industrialized countries. Conse-
quently,interest in practical aspects ofthe method is also growing.Common questions in-
clude when and how to use the systems.While the initial scanners were equipped with two
or four detector rows,current advances have led to scanners with up to 16 rows becoming
available for clinical use.And there is still more to come.
As these multislice CT systems maintain the general advantages ofCT,i.e.reliability and
short examination times,their ability to investigate large areas ofthe body in a very short
time with improved transverse resolution has broadened the potential medical applications
ofCT.Thus,new medical indications for CT,such as cardiac CT,have emerged.Some ques-
tions in diagnostic imaging,e.g.a non-invasive neck study for suspected carotid stenosis,
may in future be solved more frequently with multislice CT than with MRI.Other indica-
tions such as the staging ofrectal or laryngeal cancer may see a higher sensitivity and spe-
cificity with multislice CT than with single-slice systems.
There is also a substantial change in the way the examination is planned and carried out.
Instead ofindividual axial slices,there is a thin-collimation acquisition ofa volume.Subse-
quent reconstructions are becoming more and more important.In some protocols,such as
the cranial sinuses,only the coronal reconstructions are read at our institution,while the
axial data are not used.Thin-collimation acquisition is also useful for minimizing artefacts.
It is here that reconstructions are made in thicker slices to minimize image noise.
Care must be taken so as not to increase the patient radiation dose unnecessarily.There-
fore,whenever possible,the mAs must be adapted and reduced,the scanned volume must
be restricted and last but not least the indication for the examination must be established.
The increased speed ofmultislice CT suggests a change in the use ofintravenous contrast
agents. While the different injection doses, velocities and concentrations are currently
under investigation,the protocols in this book include a subjective recommendation for
use.
This book includes a personal selection of protocols for application with four-row or
16-row scanners.These protocols have been optimized for Siemens scanners;however,the
protocol layout and the data presented can also be employed with different bands.While we
made substantial effort to adjust the protocols to the current knowledge,preferences on the
use ofprotocols change quickly and also vary from site to site.Therefore,ifthe reader has
any comments or suggestions for variations ofthese protocols,they should not hesitate to
contact us.Please note that despite careful proofreading,there can be no liability on the part
ofthe authors for the use ofany ofthe protocols.
VI Preface
We would like to express our sincere thanks to all the contributors and to the local CT tech-
nicians.We gratefully acknowledge Prof.Maximilian Reiser,who enabled and encouraged
this early clinical experience with multislice CT in Großhadern by his personal patronage
and vision.Springer kindly supported the idea ofpublishing this volume and provided us
with invaluable assistance.We hope that everyone interested in the technique ofmultislice
CT finds this book useful.
R.Bruening Munich
T.Flohr Forchheim
Contributors
Becker,C Flohr,T.
Department ofClinical Radiology Siemens Medical Solutions
University ofMunich – Grosshadern CT Division
Marchioninistr.15 Siemensstr.1
81377 Munich 91301 Forchheim
Germany Germany
Bruening,R. Glaser,C.
Department ofClinical Radiology Department ofClinical Radiology
University ofMunich – Grosshadern University ofMunich – Grosshadern
Marchioninistr.15 Marchioninistr.15
81377 Munich 81377 Munich
Germany Germany
Eibel,R. Haw,Loke Gie
Department ofClinical Radiology Siemens Medical Solutions
University ofMunich – Grosshadern CT Division
Marchioninistr.15 Siemensstr.1
81377 Munich 91301 Forchheim
Germany Germany
Ertl-Wagner,B. Hofmann,R.
Department ofClinical Radiology Department ofClinical Radiology
University ofMunich – Grosshadern University ofMunich – Grosshadern
Marchioninistr.15 Marchioninistr.15
81377 Munich 81377 Munich
Germany Germany
Flatz,W. Hong,C.
Department ofClinical Radiology Department ofClinical Radiology
University ofMunich – Grosshadern University ofMunich – Grosshadern
Marchioninistr.15 Marchioninistr.15
81377 Munich 81377 Munich
Germany Germany
VIII Contributors
Jaeger,L. Rust,G.F.
Department ofClinical Radiology Department ofClinical Radiology
University ofMunich – Grosshadern University ofMunich – Grosshadern
Marchioninistr.15 Marchioninistr.15
81377 Munich 81377 Munich
Germany Germany
Kohl,G. Schaller,S.
Siemens Medical Solutions Siemens Medical Solutions
CT Division CT Division
Siemensstr.1 Siemensstr.1
91301 Forchheim 91301 Forchheim
Germany Germany
Kulinna,C. Schoepf,U.J.
Abteilung für Radiologie Dept.ofRadiology
AKH Wien Brighams Woman Hospital
Universität Wien Boston,MA 02115
Währinger Gürtel 18–20 USA
1090 Wien
Austria Wieser,A.
Department ofClinical Radiology
Mueller-Lisse,U. University ofMunich – Grosshadern
Department ofClinical Radiology Marchioninistr.15
University ofMunich – Grosshadern 81377 Munich
Marchioninistr.15 Germany
81377 Munich
Germany Wintersperger,B
Department ofClinical Radiology
Ohnesorge,B. University ofMunich – Grosshadern
Siemens Medical Solutions Marchioninistr.15
CT Division 81377 Munich
Siemensstr.1 Germany
91301 Forchheim
Germany
Contents
Technical Principles and Applications ofMultislice Spiral CT . . . . . . . . . . . . . . . 1
4-row Scanning
Head
Routine CCT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Contrast-Enhanced CCT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Temporal Bone and Inner Ear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
CTA Intracranial Aneurysm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Venous Sinus CTA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Cerebral Perfusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Neck
Routine Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Routine Sinuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Sinus Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Nasopharynx and Oropharynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Larynx and Hypopharynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
CTA Carotids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Chest
Routine Chest and HR-Chest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Pulmonary Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Combi Thorax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
CTA Aortic Arch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46