PROTOCOLS
What is the primary indication for CTA Chest (PE study)?
Suspected pulmonary embolism.
Typical slice thickness for a CTA Chest PE study?
0.5–1.25 mm (thin slices for vascular detail).
Standard patient position for CT Chest?
Supine, arms raised above head.
Filling defect in pulmonary artery indicates what?
Pulmonary embolism.
Patient inspires during scan and contrast looks poor. What happened?
Transient interruption of contrast (TIC).
CTA Chest (PE) requires what contrast timing technique?
Bolus tracking in the pulmonary artery (or test bolus depending on facility).
Why is high pitch often used in CTA PE studies?
To reduce motion artifact and shorten scan time.
Why must arms be raised?
To reduce beam hardening artifact and improve image quality.
Ground-glass opacities may indicate what?
Infection, inflammation, early pneumonia, COVID, pulmonary edema.
Patient has GFR 28 and suspected PE. What should you do?
Notify provider/radiologist before proceeding.
CT Chest w/ contrast is generally used to evaluate what?
Masses, infection, lymphadenopathy, malignancy, mediastinal pathology.
Typical kVp range for CTA Chest?
100–120 kVp (adjusted for patient size).
What should you check before giving IV contrast?
Allergies, GFR/renal function, IV patency.
Honeycombing pattern suggests what?
Pulmonary fibrosis.
When is CT Chest w/o contrast preferred over w/?
Interstitial lung diseases (ILD) evaluation or when contrast is contraindicated.
CT Chest w/o contrast is typically ordered for what type of evaluation?
Interstitial lung disease, pulmonary nodules, fibrosis, lung screening.
Ideal contrast injection rate for CTA Chest PE?
4–5 mL/sec.
Best IV site for CTA PE?
18–20 gauge in antecubital vein.
Enlarged mediastinal lymph nodes may suggest what?
Malignancy, lymphoma, sarcoidosis, infection.
Why is scan delay shorter in PE than routine chest w/?
Because arterial phase is required.
In a PE protocol, where should the ROI be placed for bolus tracking?
Main pulmonary artery.
Why is breath-hold coaching critical during CTA PE?
To prevent transient interruption of contrast and motion artifact.
If a patient cannot raise arms, what adjustment must you anticipate?
Increased artifact and potential need to adjust technique/mA.
What life-threatening finding must be immediately reported?
Saddle PE.
If contrast extravasates during power injection, what are your immediate steps?
Stop injection, assess site, elevate extremity, notify provider, document.