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CT Protocols

CT

Brain

Brain Plain

Indications

Stroke, trauma, hemorrhage, hydrocephalus, mass evaluation

Patient Position

Supine, head first, neutral position

Scan Range

Foramen magnum to vertex

Slice Thickness

0.5–1.25 mm (reconstruct to 5 mm for review)

kVp/mAs

120 kVp, ~250 mAs (auto mAs allowed)

Reconstruction

Axial soft tissue and bone windows, coronal/sagittal MPR

Contrast

None

Brain Plain & Contrast

Indications

Tumors, infection, vascular lesions

Patient Position

Supine, head first, neutral position

Scan Range

Foramen magnum to vertex

Slice Thickness

0.5–1.25 mm (reconstruct to 5 mm for review)

kVp/mAs

120 kVp, ~250 mAs (auto mAs allowed)

Reconstruction

Axial soft tissue and bone windows, coronal/sagittal MPR

Contrast

IV contrast 1.5 mL/kg (max 100 mL) at 2–3 mL/s, scan ~60–90 s post-injection

Brain Angiogram

Indications

Aneurysms, AVMs, stenosis, vascular injury

Patient Position

Supine

Scan Range

Foramen magnum to vertex

Slice Thickness

≤0.6 mm

kVp/mAs

120 kVp, auto mAs

Reconstruction

MIP, MPR, and 3D VR of arterial phase

Contrast

70–90 mL contrast at 4–5 mL/s with bolus tracking at circle of Willis

Head & Neck

Head & Neck Angio

Indications

Carotid stenosis, dissection, trauma

Patient Position

Supine

Scan Range

Aortic arch to vertex

Slice Thickness

≤0.6 mm

kVp/mAs

120 kVp, auto mAs

Reconstruction

MIP, curved planar reformats, and 3D VR

Contrast

80–100 mL contrast at 4–5 mL/s with bolus tracking at carotid bulb

Temporal Bones & Orbits

Temporal Bones

Indications

Cholesteatoma, ossicular chain evaluation, temporal bone fractures

Patient Position

Supine, head first

Scan Range

Petrous temporal bones bilaterally

Slice Thickness

≤0.6 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

High-resolution bone algorithm, axial and coronal MPR

Contrast

None

Orbits

Indications

Trauma, mass, infection, proptosis evaluation

Patient Position

Supine, eyes closed, avoid motion

Scan Range

Roof to floor of orbits

Slice Thickness

0.6–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Axial, coronal, and sagittal MPR in bone and soft tissue kernels

Contrast

Optional for tumors or infections

Paranasal Sinuses & Facial Bones

PNS Trauma

Indications

Facial fractures, sinus wall injury

Patient Position

Supine

Scan Range

Superior orbital rims to mandible

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone kernel axial, coronal, sagittal MPR

Contrast

None unless soft tissue injury suspected

PNS Non-trauma Pre-FESS

Indications

Chronic sinusitis pre-FESS evaluation

Patient Position

Supine

Scan Range

Inferior maxillary alveolus to frontal sinus roof

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone kernel axial, coronal, sagittal MPR

Contrast

None

Facial Fractures (Simple)

Indications

Routine trauma, screening

Patient Position

Supine

Scan Range

Superior orbital rims to mandible

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone kernel axial and coronal MPR

Contrast

None

Facial Fractures (Detailed)

Indications

Complex maxillofacial trauma

Patient Position

Supine

Scan Range

Extended to include mandible or orbital floor as needed

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone kernel axial, coronal, sagittal MPR, 3D VR

Contrast

None

Neck Soft Tissue

Neck (Plain & Contrast)

Indications

Tumors, infection, trauma

Patient Position

Supine, neck extended slightly

Scan Range

Skull base to thoracic inlet

Slice Thickness

≤1 mm

kVp/mAs

120 kVp, auto mAs

Reconstruction

Axial soft tissue and bone windows, sagittal/coronal MPR

Contrast

80–100 mL contrast at 2–3 mL/s, delay 60–70 s

Chest

Chest (Plain)

Indications

Interstitial lung disease, trauma, screening

Patient Position

Supine, full inspiration

Scan Range

Thoracic inlet to adrenal glands

Slice Thickness

1–1.25 mm

kVp/mAs

120 kVp, auto mAs

Reconstruction

Axial lung and mediastinal windows, coronal/sagittal MPR

Contrast

None

Chest (Plain & Contrast)

Indications

Masses, infection, metastases

Patient Position

Supine, full inspiration

Scan Range

Thoracic inlet to adrenal glands

Slice Thickness

1–1.25 mm

kVp/mAs

120 kVp, auto mAs

Reconstruction

Axial lung and mediastinal windows, coronal/sagittal MPR

Contrast

80–100 mL contrast at 2–3 mL/s, scan at 25–35 s

Pulmonary Angiogram (CTPA)

Indications

Pulmonary embolism

Patient Position

Supine, breath-hold at inspiration

Scan Range

Lung apices to below diaphragm

Slice Thickness

≤1 mm

kVp/mAs

100–120 kVp, auto mAs

Reconstruction

MPR, MIP, and 3D VR of arterial phase

Contrast

70–100 mL contrast at 4–5 mL/s with bolus tracking at main pulmonary artery

Chest/Abdomen/Pelvis

Chest/Abdomen/Pelvis (Male & Female)

Indications

Trauma, staging

Patient Position

Supine, full inspiration

Scan Range

Thoracic inlet to pubic symphysis

Slice Thickness

1–1.25 mm

kVp/mAs

120 kVp, auto mAs

Reconstruction

Axial soft tissue and bone windows, coronal/sagittal MPR

Contrast

100–120 mL contrast at 3–4 mL/s, portal venous phase (60–70 s)

Angiography

Renal Angiogram

Indications

Renal artery stenosis, aneurysm, vascular malformations, trauma

Patient Position

Supine, arms above head

Scan Range

Diaphragm to iliac crest

Slice Thickness

≤0.6 mm

kVp/mAs

120 kVp, auto mAs

Contrast

80–100 mL @ 4–5 mL/s, bolus tracking in abdominal aorta (~150 HU)

Reconstruction

Axial, coronal, sagittal MPR; MIP, 3D VR

Brain Angiogram

Indications

Aneurysms, AVMs, stenosis, vascular injury

Patient Position

Supine, head first, neutral

Scan Range

Foramen magnum to vertex

Slice Thickness

≤0.6 mm

kVp/mAs

120 kVp, auto mAs

Contrast

70–90 mL @ 4–5 mL/s, bolus tracking in carotid or aortic arch

Reconstruction

Axial MPR, curved planar, MIP, 3D VR

Head & Neck Angiogram

Indications

Carotid stenosis, dissection, trauma

Patient Position

Supine, head first

Scan Range

Aortic arch to vertex

Slice Thickness

≤0.6 mm

kVp/mAs

120 kVp, auto mAs

Contrast

80–100 mL @ 4–5 mL/s, bolus tracking in aortic arch (~150 HU)

Reconstruction

Axial MPR, MIP, curved planar reformats, 3D VR

Pulmonary Angiogram

Indications

Pulmonary embolism, vascular malformations

Patient Position

Supine, arms raised

Scan Range

Lung apices through costophrenic angles

Slice Thickness

≤1 mm

kVp/mAs

100–120 kVp, auto mAs

Contrast

60–80 mL @ 4–5 mL/s, bolus tracking in main pulmonary artery (~100 HU)

Reconstruction

Axial, coronal, sagittal MPR; MIP, 3D VR

Lower Limb Angiogram

Indications

Peripheral vascular disease, trauma

Patient Position

Supine, feet first

Scan Range

Abdominal aorta (L1) to feet

Slice Thickness

≤0.6–1 mm

kVp/mAs

100–120 kVp, auto mAs

Contrast

100–120 mL @ 4–5 mL/s, bolus tracking in abdominal aorta (~150 HU)

Reconstruction

MPR, MIP, 3D VR of arteries

Abdomen & Pelvis

Abdomen & Pelvis Plain (Male)

Indications

Urolithiasis, abdominal pain, trauma

Patient Position

Supine, arms above head

Scan Range

Dome of diaphragm to symphysis pubis

Slice Thickness

3–5 mm (≤1.25 mm if needed)

kVp/mAs

120 kVp, auto mAs

Contrast

None

Reconstruction

Axial soft tissue & bone windows, coronal/sagittal MPR

Abdomen & Pelvis CECT (Male)

Indications

Tumor staging, infection, trauma

Patient Position

Supine

Scan Range

Dome of diaphragm to symphysis pubis

Slice Thickness

≤1.25 mm

kVp/mAs

120 kVp, auto mAs

Contrast

80–100 mL @ 3–4 mL/s, portal venous (~70 s); arterial if needed

Reconstruction

Axial, coronal, sagittal MPR; MIP/VR if vascular eval

Abdomen & Pelvis Plain (Female)

Indications

Urolithiasis, pelvic pain

Patient Position

Supine

Scan Range

Dome of diaphragm to symphysis pubis

Slice Thickness

3–5 mm (≤1.25 mm if needed)

kVp/mAs

120 kVp, auto mAs

Contrast

None

Reconstruction

Axial soft tissue & bone windows, coronal/sagittal MPR

Abdomen & Pelvis CECT (Female)

Indications

Tumor staging, abscess, trauma

Patient Position

Supine

Scan Range

Dome of diaphragm to symphysis pubis

Slice Thickness

≤1.25 mm

kVp/mAs

120 kVp, auto mAs

Contrast

80–100 mL @ 3–4 mL/s, portal venous (~70 s); arterial if required

Reconstruction

Axial, coronal, sagittal MPR; MIP/VR for vascular details

KUB (Male)

Indications

Urolithiasis, flank pain

Patient Position

Supine

Scan Range

Kidneys to bladder base

Slice Thickness

3–5 mm

kVp/mAs

120 kVp, auto mAs

Contrast

None

Reconstruction

Axial soft tissue & bone windows, coronal MPR for ureters

KUB (Female)

Indications

Urolithiasis, flank pain

Patient Position

Supine

Scan Range

Kidneys to bladder base

Slice Thickness

3–5 mm

kVp/mAs

120 kVp, auto mAs

Contrast

None

Reconstruction

Axial soft tissue & bone windows, coronal MPR for ureters

Upper Limb

Wrist

Indications

Fracture assessment, non-union, carpal instability

Patient Position

Supine, arm above head or by side, wrist neutral

Scan Range

Mid-radius/ulna to metacarpal heads

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone & soft tissue kernels, MPR coronal/sagittal, 3D VR

Contrast

None unless infection/vascular

Elbow

Indications

Complex fractures, instability, prosthesis assessment

Patient Position

Supine, arm above head or by side, elbow extended

Scan Range

Distal humerus to proximal forearm

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone & soft tissue kernels, MPR coronal/sagittal/oblique

Contrast

Not routine

Shoulder

Indications

Fractures, prosthesis planning, instability, tumors

Patient Position

Supine, arm neutral

Scan Range

Entire scapula, glenoid, proximal humerus, clavicle

Slice Thickness

0.6–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone & soft tissue algorithms, MPR coronal/sagittal oblique

Contrast

Optional for tumor/infection

Lower Limb

Knee

Indications

Complex fractures, tibial plateau injuries, pre-op alignment

Patient Position

Supine, knee neutral

Scan Range

Above femoral condyles to below tibial tuberosity

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 150–200 mAs

Reconstruction

Bone & soft tissue kernels, MPR coronal/sagittal, 3D VR

Contrast

Not routine

Pelvis & Hip Joints

Indications

Pelvic fractures, acetabular fractures, prosthesis evaluation

Patient Position

Supine, feet internally rotated ~15°

Scan Range

Iliac crest to mid-femur

Slice Thickness

1 mm

kVp/mAs

120 kVp, 200–250 mAs

Reconstruction

Bone kernel axial, MPR coronal/sagittal, 3D VR

Contrast

Optional for tumor/infection

Angiogram Lower Limbs

Indications

Peripheral arterial disease, trauma, bypass planning

Patient Position

Supine, legs extended

Scan Range

Diaphragm to feet

Slice Thickness

0.6–1 mm

kVp/mAs

100–120 kVp, auto mAs

Reconstruction

Arterial phase, MPR, MIP, 3D VR

Contrast

80–100 mL contrast @ 4–5 mL/s

Spine

Cervical Spine

Indications

Trauma, degenerative disease, pre-op planning

Patient Position

Supine, neck neutral

Scan Range

Base of skull to T2

Slice Thickness

0.5–1 mm

kVp/mAs

120 kVp, 200 mAs

Reconstruction

Bone & soft tissue kernels, MPR sagittal/coronal

Contrast

Use for infection/tumor/post-op

Lumbar Spine

Indications

Trauma, degenerative changes, pre-op planning

Patient Position

Supine, legs extended or knees flexed

Scan Range

T12 to sacrum

Slice Thickness

1–2 mm

kVp/mAs

120 kVp, 250 mAs

Reconstruction

Bone & soft tissue kernels, MPR sagittal/coronal

Contrast

Use for infection/tumor/post-op