CT — Pumn (MCB)

Updated 05/05/24 CT Wrist Reviewed 05/15/25 Indications - trauma, fracture, dislocation, pain, bone tumor, soft tissue mass, infection, abscess, soft tissue gas, osteomyelitis, pre/post surgical evaluation. Bill under CT Wrist charges. GENERAL SCAN NOTES Remove any metal from the imaging field of view. Patient positioning: Preferred - Patient prone with arm over head in center of scanner, palm down with fingers straight and close together. Option 1 - Patient lateral decubitus position with affected arm extended over head with palm up. Topogram - base of the metacarpals through distal radioulnar joint. Craniocaudal scan coverage - base of the metacarpals through distal radioulnar joint. Adjust FOV (field of view) on topogram to smallest without cropping anatomy. IV Contrast: 100 mL Omnipaque-300, inject at 2.5 mL/sec, 60 secs scan delay. 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. SIEMENS PARAMETERS & RECONS Scan
Care
Scan
Acq Coll Rot Mode kV mAs Care
Dose kV & Lvl Pitch Time Time Sensation 16 spiral 120 120 on NA 0.55 16 0.75 1.0 9.1 Go Up 32 spiral Sn 110 366 on on 75 0.40 32 0.7 1.0 6.7 Sensation 64 spiral 120 120 on 0.90 64 0.6 1.0 3.5 NA Definition 64 spiral 120 100 on off 0.80 64 0.6 1.0 3.9 Go Top 64 spiral Sn 100 898 on 0.40 64 0.6 1.0 3.9 on 75 Drive 128 spiral 120 70 on off 0.80 128 0.6 1.0 2.0 0.80 192 0.6 1.0 1.3 Force 192 spiral 120 70 on off IR
Recon
Name of Series Thick Interval Kernel Window Lvl Direction AX BONE 2.0 2.0 Br59 / B60f bone/osteo 3 head/feet COR BONE 2.0 2.0 Br59 / B60f bone/osteo 3 front/back SAG BONE 2.0 2.0 Br59 / B60f bone/osteo 3 left/right AX SOFT 2.0 2.0 Br40 / B31f abdomen 3 head/feet Send the above recons on the pre contrast scan (if without only) or on the post contrast scan (if IV given). Send only the following recon on the pre contrast scan (if without and with). AX SOFT PRE 2.0 2.0 Br40 / B31f abdomen 3 head/feet

CT Wrist GE PARAMETERS & RECONS Scan
Smart
Slice
Beam
Dose
Pitch Speed Rot
Type SFOV kV mA
Range Noise
Index mA Thick Coll Time Red ASIR Scan
Time on 1.25 10 0.938 9.37 0.5 LS 16 helical large 120 100-440 17.68 NA NA 3.2 Opt 540 helical large 120 100-440 17.68 on 1.25 10 0.938 9.37 0.5 NA NA 3.2 LS VCT 64 helical large body 120 100-450 16.00 on 1.25 40 0.984 39.37 0.5 20 20 0.8 Disc VCT 64 helical large body 120 100-450 16.00 on 1.25 40 0.984 39.37 0.5 NA NA 0.8 Window
Recon Name of Series Thickness Interval Recon
Algorithm Width/Level Direction AX BONE 1.25 1.25 bone full 2500/480 head/feet Must be first recon. COR BONE 1.25 1.25 bone full 2500/480 front/back SAG BONE 1.25 1.25 bone full 2500/480 left/right AX SOFT 1.25 1.25 std full 400/40 head/feet Send the above recons on the pre contrast scan (if without only) or on the post contrast scan (if IV given). Send only the following recon on the pre contrast scan (if without and with). AX SOFT PRE 1.25 1.25 std full 400/40 head/feet PHILIPS PARAMETERS & RECONS Scan
Dose
3D
Rot Scan
Mode kV Avg
mAs Index Dose Pitch Detect Colli Time Time 1.00 1.9 Incisive 128 helical 120 32 20 off 0.80 64 0.625 Name of Series Thick Interval Filter Window iDose Recon
Direction AX BONE 2.0 2.0 YC bone 3 head/feet COR BONE 2.0 2.0 YC bone 3 front/back SAG BONE 2.0 2.0 YC bone 3 left/right AX SOFT 2.0 2.0 B abdomen 3 head/feet Send the above recons on the pre contrast scan (if without only) or on the post contrast scan (if IV given). Send only the following recon on the pre contrast scan (if without and with). head/feet AX SOFT PRE 2.0 2.0 B abdomen 3

CT Wrist Coronal Plane (line through radial and ulnar styloids) Sagittal Plane (perpendicular to coronal plane)