This document provides guidelines for performing CT angiography exams of various body parts to evaluate for pulmonary embolism, deep vein thrombosis, and other vascular conditions. It describes patient positioning, contrast injection protocols, scan parameters and reconstruction techniques for CT angiography of the chest, upper extremities, lower extremities, brain, and abdomen. The goal is to comprehensively examine the vasculature with thin slices and multiplanar reconstructions to detect blood clots, aneurysms, and other abnormalities.

6.  CHEST PAIN
 FOLLOW UP OF KNOWN PE

7.  Total or partial occlusion of a pulmonary artery
by thrombus or embolus.
 It may be:
 Central: involving main, right, left or all the major
pulmonary arteries) Life threatening.
 Peripheral: involving one or more peripheral
branch.

8.  This is usually an EMERGENCY EXAM.
 Patient lies supine on the couch.
 Sometimes patient is dyspnic so
 You may put him in semi setting position
 Put 18-20 G cannula in the anticubital vein.
 Teach the patient how to HOLD HIS
BREATH.
 The most important issue is
NO STRAINING

9.  The breath hold period is only about 5 s.
 Scan direction is feet first.
FOV LARGE
Slice thickness 0.5 mm
mA Adjust to B.Wt (400)

10. Use non Ionic contrast.
Volume 60 ml
Flow rate 6 ml/s
Use sure start technique:
Put ROI on the main PA
Preset HU is 90

11. Again remember it is an
EMERGENCY EXAM
Reconstruction is done by:
MIP but take care ????
MPR (coronal, sagittal &
oblique)

19.  Because the subclavian artery arises
from the aortic arch so the examination
must include the aortic arch.
 We better examine only one upper limb.
mA
200-250
except Aquilion 64
(sure exposure)
Slice thickness 0.5-0.75 mm
FOV LL

20.  Patient is put in supine position with
the limb in question is beside him in
comfort position.
 18-20 G Cannula is put in the other side.
 Inject contrast.
 Put ROI on descending aorta.
 Preset HU is 160

21. Contrast volume is 100 cc.
Flow rate 4-5 ml/sec.
Table feed direction is FEET
FIRST. Then take another run in
the opposite direction.
It is better to make the patient
holding his breath during scan
(20 s).

23. CTA OF
LOWER EXTREMITY

25.  FOV extends from the lower thorax
(diaphragm) to the toes, with an average
scan length of 110–130 cm.
 We examine both lower limbs.
mA
400
except Aquilion 64
(sure exposure)
Slice thickness 0.5-0.75 mm
FOV L

26.  Patient is put in supine position.
 18-20 G Cannula.
 We take two runs:
oFirst head first.
oSecond feet first.
 Amount contrast 100 ml
 Flow rate 5 ml/s As UL
 As usual we use sure start.
 ROI on descending aorta.
 HU is 250.

33.  Field of view like that of any brain
examination.

34. mA 400
Slice thickness 0.5 mm
FOV S (240)

35.  Axail, Sagittal and coronal.
 MIP.

38. Patient is put in supine position.
18-20 G Cannula.
We take two runs:
oFirst head first.
oSecond feet first.
Sure start technique: ROI on:
 Ascending aorta (HU 130)
 Internal carotid artery (HU 100)

39. Hemorrhage:
Aneurysm
AVM
Infarction.

41. Aorta
Arises from left ventricle
Parts:
• Ascending aorta
• Arch
• Descending thoracic
aorta
• Abdominal aorta

42.  Field of view from lower neck to end of pubic bone

43. mA 350
Slice thickness 0.5 mm
FOV LL

44. Patient is put in supine position.
18-20 G Cannula.
We take two runs:
oFirst head first.
oSecond feet first.
Sure start technique: ROI on:
 Descending aorta (HU 150)

45.  Axail, Sagittal, coronal & CPR.
 MIP.

47. Aneurysm
Dissection
Coarctation