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Which of the following is a common purpose for abdominal CT imaging?
What is the required slice thickness for routine chest CT imaging?
Which of the following types of neoplasms is commonly associated with brain metastases in children?
Which contrast administration route is frequently used in CT procedures?
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What is the typical slice thickness used for image reformation during CT scans?
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What is the purpose of oral contrast in the initial study of the pancreas?
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What is the required iodine contrast amount for evaluating a renal neoplasm?
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Which imaging technique is mandated for evaluating a suspected renal neoplasm?
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What is the recommended scan timing after the initiation of CM for renal imaging?
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What is the key aspect evaluated during the assessment of images in imaging protocols?
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What is the purpose of bolus administration in computed tomography?
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What is a safe dilution percentage for oral or rectal water-soluble contrast media?
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In a CT scan protocol for stroke, what type of scan is mandatory?
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What should be included in filming during a head CT scan for trauma?
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Which is NOT a key point in evaluating CT images for neoplasms?
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How should contrast media be handled before administration to ensure patient safety?
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What constitutes a completed stroke in clinical terminology?
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What is the significance of using thin slices in obtaining head CT scans?
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Study Notes
Computed Tomography (CT) Contrast Administration
- Bolus administration (manual or automatic) maximizes plasma iodine concentration and tissue enhancement.
- Water-soluble contrast media alternatives include diatrizoate meglumine and diatrizoate sodium for GI tract opacification.
- Careful preparation of water-soluble solutions is essential; 2-5% dilution is safe, while 15-40% may lead to hypovolemia.
- Standard dilution involves mixing 20-30ml of contrast media in 1,000ml of solution (970ml of H2O).
CT Acquisition Protocol for Head/Neck, Thorax, and Abdomen
Head CT Scan Protocol
- Used for post-traumatic abnormalities, suspected brain neoplasms, aneurysms, abscesses, atrophy, and metastases.
- Trauma evaluation requires a plain study without contrast; thin slices (2-3mm) are necessary for base of the skull.
- Include brain parenchyma and bone windows in imaging; follow-up studies may require contrast.
Stroke/CVA Protocol
- Stroke ranks as the third leading cause of death in the US.
- Terminology includes Transient Ischemic Attack (TIA), Reversible Ischemic Neurologic Deficit (RIND), and Completed Stroke.
- Routine head CT plan (2-3mm for base, 10mm for brain) generally does not require contrast, except in traumatic cases.
Neoplasm Protocol
- Primary CNS neoplasms occur at a rate of 5-6 per 100,000 adults; 20% of malignancies under 20 years are brain tumors.
- Key evaluation points include lesion location, extent, and anatomical classification (intraaxial vs. extraaxial).
Pancreas Protocol
- Initial study necessitates non-contrast imaging.
- Scanning should begin at the iliac crest and move upward in 5mm intervals.
- Involves a bolus IV injection of contrast (3ml/sec) and a 750-1000ml oral contrast solution.
- For helical scanners, specific delays for arterial (30-35 sec) and venous phases (70 sec) are critical.
Kidney Protocol
- CT is preferred for evaluating renal neoplasms; both pre- and post-contrast images are mandatory.
- Pre-contrast images require 5mm increments; lesions <2cm necessitate 3-5mm contiguous sections.
- Administer 30-40g of iodine (150-180ml) IV contrast bolus; scans taken after 60 seconds from diaphragm to kidney.
Image Assessment and Quality Control
- Isocenter refers to the absolute center of the gantry; crucial for accurate imaging.
- In-plane resolution denotes image resolution in the x-y direction.
- CT scans provide detailed information on bone abnormalities, with thin slices (1-2mm) used for reformation.
Intracranial Metastatic Disease Protocol
- Common parenchymal brain metastases originate from lung, breast, melanoma, and genitourinary and gastrointestinal tracts in adults; sarcomas and germ cell tumors in children.
- Both plain and contrast-enhanced studies are recommended with specific bone and parenchyma windows.
Chest CT Scan Protocol
- Acts as a diagnostic adjunct to radiography, useful for mediastinal lesions, aneurysms, abscesses, and cardiac diseases.
- Requires contrast media, with various methods for administration; images typically taken in 10mm slice thickness.
Abdomen CT Scan Protocol
- Recognized for speed and accuracy in diagnosing abdominal issues.
- Abdominal CT is indicated for abnormalities affecting various organs including liver, pancreas, kidneys, adrenal glands, and pelvic tumors.
- Reduction in use of ERCP and lymphangiography due to the effectiveness of abdominal CT.
Contrast Administration Essentials
- Understanding types, dosages, purposes, and administration routes for common CT procedures is vital for optimal imaging outcomes.
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Description
This quiz covers the essential patient preparation for commonly performed computed tomography contrast studies. It focuses on the administration of oral and rectal contrast media, including water-soluble solutions. Understanding the impact of contrast on tissue enhancement and maximizing plasma iodine concentration is key for students in the medical field.
