CT — Cistografie (MCB)

Updated 02/05/26 CT Cystogram Reviewed 02/05/26 Indications - bladder mass, trauma, leak, rupture, post surgical injury. Use CT Pelvis w/o Contrast charge (if IV not used) or CT Pelvis w/o + w/ Contrast (if IV given). GENERAL SCAN NOTES Move the patient's arms over his/her head if possible. Remove any metal from the imaging field of view. Topogram - iliac crests through pubic symphysis (obtained during end inspiration). Craniocaudal scan coverage - iliac crests through pubic symphysis (obtained during end inspiration). Adjust FOV (field of view) on topogram to smallest without cropping anatomy. Bladder Contrast: Place order in EMR for Omnipaque 240 in NS 500 mL (CT bladder irrigation) for Pharmacy to make. IV Contrast: Administer weight-based Omnipaque-300 - 1 mL/kg up to 150 mL (100 mL minimum). Inject at 2.5 mL/sec followed by 40 mL saline flush, 20-gauge or larger in forearm or more proximal. Only perform venous scan if exam ordered w/ + w/o contrast. Oral Contrast: generally not given for this protocol. For GE scanners, it is essential for the 1st recon thickness on the scanner to match the 1st recon thickness in this protocol book for the prescribed Noise Index to be valid. The 1st recon should generally be the thickest recon in the protocol. Urinary Catheter Instructions: Clamp the urinary catheter prior to the patient coming to CT. You need the bladder at least partially distended for the exam. Identify the type of urinary catheter (i.e. Foley versus suprapubic). Differentiate the urine drainage port from the balloon port. NEVER USE BALLOON PORT. Ensure that the urinary catheter is clamped prior to connecting the contrast mixture. Connect the contrast mixture tubing to the drainage port. DO NOT USE BALLOON PORT. Remember to unclamp the urinary catheter prior to the patient leaving the CT department.

CT Cystogram SIEMENS PARAMETERS & RECONS For the Pre Contrast, Venous, Cystogram and Post Void phases: Scan
Care
Rot Scan
Mode kV mAs Care
Dose kV & Lvl Pitch Acq Coll Time Time Sensation 16 spiral 120 200 on NA 0.80 16 1.5 0.5 13.0 Go Up 32 spiral 130 92 on on 145 0.80 32 0.7 0.8 22.3 Sensation 64 spiral 120 200 on NA 1.20 24 1.2 0.5 7.2 Definition 64 spiral 120 180 on 0.5 21.7 off 0.60 64 0.6 Go Top 64 spiral 120 112 on on 145 0.80 64 0.6 0.5 8.1 Drive 128 spiral 120 147 on on 0.60 128 0.6 0.5 10.9 Force 192 spiral 120 147 on on 0.60 192 0.6 0.5 7.2 PRE CONTRAST PHASE IR
Name of Series Thick Interval Window Recon
Direction Kernel Lvl AX PRE 3.0 3.0 mediastinum head/feet Br40 / B41f 3 SAG PRE 3.0 3.0 mediastinum left/right Br40 / B41f 3 VENOUS PHASE (70 secs) AX VENOUS 3.0 3.0 mediastinum head/feet Br40 / B41f 3 COR VENOUS 3.0 3.0 mediastinum front/back Br40 / B41f 3 SAG VENOUS 3.0 3.0 Br40 / B41f mediastinum left/right 3 CYSTOGRAM PHASE Fill the bladder via the drainage catheter under gravity with up to 300 mL of contrast mixture. Stop infusing contrast if the patient experiences significant pain. AX CYSTO 3.0 3.0 mediastinum head/feet Br40 / B41f 3 COR CYSTO 3.0 3.0 mediastinum front/back Br40 / B41f 3 SAG CYSTO 3.0 3.0 mediastinum left/right Br40 / B41f 3 POST VOID PHASE Perform a post void scan if the patient has had recent bladder surgery, bladder procedure or trauma. Unclamp the drainage catheter and allow to drain for 5 mins before scanning the patient. 3 AX POST VOID 3.0 3.0 mediastinum head/feet Br40 / B41f

CT Cystogram GE PARAMETERS & RECONS For the Pre Contrast, Venous, Cystogram and Post Void phases: Scan
Smart
Slice
Beam
Dose
Scan
Speed Rot
Type SFOV kV mA
Range Noise
Index mA Thick Coll Pitch Time Red ASIR Time LS 16 helical large 120 50-440 16.36 on 2.5 20 1.375 27.50 0.6 NA NA 4.4 Opt 540 helical large 120 50-440 16.36 on 2.5 20 1.375 27.50 0.6 NA NA 4.4 LS VCT 64 helical large body 120 50-650 16.36 on 2.5 40 1.375 55.00 0.5 50 50 1.8 Disc VCT 64 helical large body 120 50-650 16.36 on 2.5 40 1.375 55.00 0.5 NA NA 1.8 PRE CONTRAST PHASE Window
Recon
Name of Series Thickness Interval Recon
Algorithm Width/Level Direction AX PRE 2.5 2.5 std full 400/40 head/feet Must be first recon. SAG PRE 2.5 2.5 std full 400/40 left/right VENOUS PHASE (70 secs) AX VENOUS 2.5 2.5 std full 400/40 head/feet COR VENOUS 2.5 2.5 std full 400/40 front/back Must be first recon. SAG VENOUS 2.5 2.5 std full 400/40 left/right CYSTOGRAM PHASE Fill the bladder via the drainage catheter under gravity with up to 300 mL of contrast mixture. Stop infusing contrast if the patient experiences significant pain. AX CYSTO 2.5 2.5 std full 400/40 head/feet Must be first recon. COR CYSTO 2.5 2.5 std full 400/40 front/back SAG CYSTO 2.5 2.5 std full 400/40 left/right POST VOID PHASE Perform a post void scan if the patient has had recent bladder surgery, bladder procedure or trauma. Unclamp the drainage catheter and allow to drain for 5 mins before scanning the patient. AX POST VOID 2.5 2.5 std full 400/40 head/feet Must be first recon.

CT Cystogram PHILIPS PARAMETERS & RECONS For the Pre Contrast, Venous, Cystogram and Post Void phases: Scan
Dose
3D
Scan
Mode kV Avg
mAs Index Dose Pitch Detect Colli Rot Time Time Incisive 128 helical 120 115 20 on 1.00 64 0.625 0.75 3.8 PRE CONTRAST PHASE Name of Series Thick Interval Filter Window iDose Recon
Direction AX PRE 3.0 3.0 B mediastinum 3 head/feet COR PRE 3.0 3.0 B mediastinum 3 front/back VENOUS PHASE (70 secs) AX VENOUS 3.0 3.0 B mediastinum 3 head/feet COR VENOUS 3.0 3.0 B mediastinum 3 front/back 3.0 3.0 B mediastinum 3 left/right SAG VENOUS CYSTOGRAM PHASE Fill the bladder via the drainage catheter under gravity with up to 300 mL of contrast mixture. Stop infusing contrast if the patient experiences significant pain. AX CYSTO 3.0 3.0 B mediastinum 3 head/feet COR CYSTO 3.0 3.0 B mediastinum 3 front/back SAG CYSTO 3.0 3.0 B mediastinum 3 left/right POST VOID PHASE Perform a post void scan if the patient has had recent bladder surgery, bladder procedure or trauma. Unclamp the drainage catheter and allow to drain for 5 mins before scanning the patient. 3.0 3.0 B mediastinum 3 head/feet AX POST VOID