Tomography Technique Lecture 7: CT scan Vertebrals Prepared by: Behzad Ommani Master of Medical Engineering Instructor Radiology Group September, 2012
Lumbar The Lumbar Spine The two commonest reasons for imaging the lumbar spine are: Lumbar disc disease, most commonly at L5/S1 and L4/L5; Spinal stenosis, i.e. narrowing of either or both the spinal canal and lateral recesses
Lumbar Patient position : Supine, Both arms should be raised above the head. This is the planning scan and is usually an anteroposterior (AP) view and lateral. Start position : Zero to symphysis pubis End position : Commence 35 cm Lumbar Protocol
Slice thickness 3-5 mm
Table increment 3-5 mm Algorithm Standard Kilovoltage 120-140 kV mAs per slice 250-400 mAs Scan field of view 48 cm Display field of view 15 cm Window width (WW) 500/1500 Window level (WL) 60/250 Lumbar Disc
Lumbar Stenosis From the lateral scan projection radiograph, plan three axial sections through each disc space, from L5/S1 up to L1/L2, with the middle section passing through the middle of and parallel to each disc space. The axial scans should be 5 mm in thickness and separated using a table increment of 10 mm Lumbar Stenosis
Cervical MR imaging should always be used to investigate cervical disc disease but, due to the lack of signal from bone, it is often very difficult to assess the degree of encroachment on cervical nerve roots from osteophyte formation within the intervertebral foramen. Cervical Spine
Patient position : Supine, Both arms should be raised above the head. This is the planning scan and is usually an anteroposterior (AP) view and lateral. Start position : Zero to 5 cm above orbitomeatal baseline End position : Length, 25 cm Cervical Spine Protocol
Axial scans (helical)
Slice thickness 1-3 mm Table pitch 1-1.5 Algorithm Standard Kilovoltage 120 kV mAs per slice 200-400 mAs Scan field of view 25 cm Display field of view 15 cm Window width 500/1500 Window level 60/250
postnasal space scan Patient position : Supine with head in head cushion on table top Lateral scan projection radiograph is optional Start position Skull base End position : Epiglottis Gantry angle : Parallel to infraorbital meatal line Protocol for postnasal space scan
Slice thickness 5 mm
Table increment 5 mm Kilovoltage 120 kV mAs per slice 250 mAs Algorithm Soft/standard Scan field of view 25 cm Display field of view 22 cm Window width 400 Window level 20
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