Updated 06/15/24 CT Head Routine Reviewed 05/14/25 Indications - stroke, hemorrhage, altered mental status, headache, trauma, dizziness, syncope, mass. Do not perform a with IV only exam unless a noncontrast head has been performed within last 6 hours. Change order to CT Head w/o + w/. GENERAL SCAN NOTES Remove any metal from the imaging field of view. Position patient's head so that the line connecting the lateral canthus of the eye and the EAC is perpendicular to the CT tabletop. For all adult head studies, it is important for image quality purposes to position the patient in the center of the scan field. Use the lateral laser beam to make sure that the patient is positioned in the center. Topogram - C1 vertebrae through top of head. Craniocaudal scan coverage - C1 vertebrae through top of head. Avoid scanning the lens of the eyes. Adjust FOV (field of view) on topogram to smallest without cropping anatomy. IV Contrast: 100 mL Omnipaque-300, inject at 1 mL/sec, 3 mins 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.

CT Head Routine SIEMENS SPIRAL SCAN PARAMETERS & RECONS Scan
Care
Scan
Mode kV mAs Care
Dose Pitch Acq Coll Rot kV & Lvl Time Time Sensation 16 spiral 120 320 on 0.55 16 1.5 NA 1.0 9.1 Go Up 32 spiral 130 230 off 0.55 32 0.7 1.0 9.7 off Sensation 64 spiral 120 380 on NA 0.85 64 0.6 1.0 7.4 Definition 64 spiral 120 350 on on 0.55 64 0.6 1.0 11.4 6.8 off 0.55 64 0.5 1.0 Go Top 64 spiral 120 265 off Drive 128 spiral 120 332 on 0.55 128 0.6 on 1.0 5.7 Force 192 spiral 120 332 on 0.55 192 0.6 on 1.0 3.8 Recon
Name of Series Thick Interval Kernel Window IR
Lvl Direction AX SOFT 4.0 4.0 Hr40 / H31s cerebrum 3 feet/head TRUE AX SOFT 4.0 4.0 Hr40 / H31s cerebrum 3 feet/head front/back COR SOFT 3.0 3.0 Hr40 / H31s cerebrum 3 SAG SOFT 3.0 3.0 Hr40 / H31s cerebrum 3 left/right AX BONE 4.0 4.0 Hr64 / H70s bone 3 feet/head 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 4.0 4.0 Hr40 / H31s cerebrum 3 feet/head

CT Head Routine SIEMENS SEQUENTIAL SCAN PARAMETERS & RECONS Scan
Care
Care

Colli-
Feed / Scan Cycle mAs Dose Detect mation Scan Time Time Mode kV Ref kV & Lvl Sensation 16 sequential 120 310 on 18.0 NA 12 1.5 1.0 2.0 Go Up 32 sequential 130 191 on on 20.0 1.0 2.0 32 0.70 Sensation 64 sequential 120 1.2 430 on 28.5 NA 24 1.0 2.0 Definition 64 sequential 120 390 on on 17.0 1.0 64 0.6 2.0 Go Top 64 sequential 120 265 2.0 64 0.6 off 34.5 1.0 off Drive 128 sequential 120 273 on on 34.5 2.0 4.0 32 1.2 Force 192 sequential 120 on 273 on 48.0 1.0 3.5 192 0.6 IR
Recon
Name of Series Kernel Thick Interval Direction Window Lvl 4.8 4.8 AX SOFT Hr40 / H31s cerebrum feet/head 3 4.5 (16 slice) 4.5 (16 slice) 4.8 4.8 TRUE AX SOFT Hr40 / H31s cerebrum 3 feet/head 4.5 (16 slice) 4.5 (16 slice) 3.0 3.0 COR SOFT Hr40 / H31s 3 cerebrum front/back SAG SOFT 3.0 3.0 Hr40 / H31s cerebrum 3 left/right 4.8 4.8 AX BONE Hr64 / H70s bone 3 feet/head 4.5 (16 slice) 4.5 (16 slice) 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). 4.8 4.8 Hr40 / H31s cerebrum 3 feet/head 4.5 (16 slice) 4.5 (16 slice) AX SOFT PRE

CT Head Routine GE PARAMETERS & RECONS HELICAL SCAN Scan
Smart
Slice
Beam
Dose
Scan
Pitch Speed Rot
Type SFOV kV mA
Range Noise
Index mA Thick Coll Time Red ASIR Time LS 16 helical head 120 50-250 3.54 on 5.0 10 0.562 5.62 0.8 NA NA 17.1 on 5.0 10 0.562 5.62 0.8 Opt 540 helical head 120 50-250 3.54 NA NA 17.1 LS VCT 64 helical head 120 50-210 2.47 on 5.0 20 0.531 10.62 0.7 30 30 7.9 Disc VCT 64 helical head 120 50-210 2.47 on 5.0 20 0.531 10.62 0.7 NA NA 7.9 AXIAL SCAN Scan
Smart Pitch /
Slice
Beam
Rot
Dose
ASIR SFOV kV Manual
Thick Coll Time Red Type mA mA Speed 10 5 0.5 LS 16 axial head 120 NA 480 off 2i NA Opt 540 axial head 120 480 off 5 10 2i 0.5 NA NA LS VCT 64 0.5 axial head 120 5 off 480 20 10 2i 20 Disc VCT 64 axial head 120 600 off 5 10 2i 0.5 NA NA RECONS Window
Recon
Name of Series Thickness Interval Recon
Algorithm Width/Level Direction AX SOFT 5.0 5.0 std full 80/40 feet/head Must be first recon. TRUE AX SOFT 5.0 5.0 std full 80/40 feet/head COR SOFT 2.5 2.5 std full 80/40 front/back SAG SOFT 2.5 2.5 std full 80/40 left/right AX BONE 5.0 5.0 bone full 2500/480 feet/head 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 5.0 5.0 std full 80/40 feet/head

CT Head Routine PHILIPS PARAMETERS & RECONS HELICAL SCAN Scan
Dose
3D
Scan
Detect Colli Rot Mode kV Avg
mAs Pitch Index Dose Time Time Incisive 128 helical 120 310 37 on 0.70 64 0.625 1.0 4.3 AXIAL SCAN Scan
Dose

Colli-
Feed / Scan Cycle kV mAs 3D
Detect mation Scan Time Time Mode Index Dose Incisive 128 axial 120 280 NA 16 NA 0.625 10.0 1.0 1.7 RECONS Name of Series Thick Interval iDose Recon
Filter Window Direction AX SOFT 4.0 4.0 UB brain 1 feet/head TRUE AX SOFT 4.0 4.0 UB brain 1 feet/head COR SOFT 3.0 3.0 UB brain 1 front/back SAG SOFT 3.0 3.0 UB brain 1 left/right AX BONE 4.0 4.0 YB bone 1 feet/head 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). feet/head AX SOFT PRE 4.0 4.0 UB brain 1