Abdominal CT

I have been very busy learning all of the abdominal protocols in CT. We have a specific protocol for everything. This can range from generalized abdominal pain, n/v, hematuria, renal mass, adrenal mass, liver issues, pancreatic issues, etc. Some cases have delayed images and some cases have a venous and arterial phase. On any day I will scan a combination of any or all of these protocols. One of my favorite abdominal protocols is a liver protocol. This study has a venous and arterial phase. The arterial phase shows the liver and vessels very bright and highlighted. The venous phase is still interesting but just looks like a general abdominal series.

Brain Bleed

This week in CT I scanned an 83 year-old female who had experienced trauma. She was not verbally responsive but she was awake. This patient had large hematomas on the anterior portion of her skull and bruising around one of her eyes. All of the bruising had begun to yellow indicating that her injuries were not new. After the head CT it was determined that she had a large bleed on the left anterior portion of her brain. The emergency room was not aware of any previous brain bleed from this patient. I am glad that we were able to help with this patient's treatment. However, I felt very sorry for this patient who had not been properly cared for at home.

Coronary Calcium Scoring

At my facility we do a large amount of Coronary Calcium Score Exams everyday. This exam is offered to the public as a promotional procedure that the patient self-orders. This exam is used to detect the presence of atherosclerosis. If any calcification is detected by the CT scanner it can indicate the presence of plaque in the vessel. The calcification that is detected by the CT scanner is Calcium Scored by the software to determine the regions that contain calcium. This report is intended to help your physician determine if further cardiac care is needed. A Calcium Score of zero shows no identifiable plaque, 1-10 minimal plaque burden, 11-100 mild plaque burden, 101-400 moderate plaque burden, and over 400 extensive plaque burden. These ranges indicate the likelihood of coronary artery disease. The results of this exam are to be used as a risk assessment test and not to be used as a substitute for examination by a physician.

CTA Chest

CTA Chest is becoming a very common exam. Almost everyone who presents with chest pain or sob gets a CTA Chest rather than a CT Chest w/contrast. CTA Chest exam is done to diagnose a Pulmonary Embolism (PE). A PE is a blood clot in the lung. This blood clot usually originates from somewhere else in the body and moves to the lung where it becomes lodged causing damage. A PE can be caused by immobilization such as stroke, travel (sitting), trauma, surgery, obesity, etc. Pregnancy can also be a leading cause of PE due to an increase in blood clots. The CTA Chest exam diagnoses a PE by injection of contrast at a high rate (4ml/sec.) This injection is then bolus tracked at the pulmonary artery to highlight a PE.

CT

I have been very busy in CT. I am learning so much and I am almost overwhelmed at times. One of my biggest challenges is learning the specific protocols for every doctor and every exam. It can be challenging at times but I am enjoying it very much. I am learning everything from head work, abd./pelvis, chest, extremities, etc. I do not see very much trauma at my facility, but I still see some very interesting cases daily.