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Computed Tomography of Spine

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Sacro-iliac joints. Fine slices. MPR's. Indications ... Iliac crests. Patient Mid-sagittal plane. Coverage. Superiorly. From 5th lumbar vertebra ... – PowerPoint PPT presentation

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Title: Computed Tomography of Spine


1
Computed Tomography of Spine
2
CT Cervical Spine
  • Cervical spine
  • Fine slices
  • MPRs

3
Indications
  • When thinking about indications for any CT, try
    thinking about what anatomy is located within the
    region being demonstrated.
  • It is important to know where you will be
    scanning
  • CT Cervical Spine!
  • Anatomy?
  • What can go wrong?
  • Where are the most common pathologies

4
Indications
  • Cervical Spine
  • Trauma
  • Neck or arm pain
  • Suspected cord compression
  • Headaches

5
Contraindications
  • Contraindications
  • NO previous plain films.

6
Patient preparation
  • Patient changed into radiolucent gown
  • Artifacts removed (as per soft tissue neck)
  • Necklace
  • Bra
  • Piercings (if possible)
  • Hearing aids
  • Dentures

7
Scan parameters
  • Scan type
  • Axial
  • Helical (for trauma)
  • Anteroposterior and lateral scout
  • Coverage
  • BOS to 1st thoracic vertebra
  • Comments
  • For patients with large shoulders, arms straps
    with traction should be applied
  • Angle parallel to disc space

8
Scan technique
  • Patient supine
  • Head first
  • Anatomical landmark
  • Sternal Notch

9
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10
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11
Coverage
  • Inferiorly
  • 1st thoracic vertebra
  • Superiorly
  • BOS

12
Image reconstruction
  • 1st reconstruction
  • 2mm/2mm (soft tissue)
  • 2nd reconstruction
  • 2mm / 2mm (bone)
  • Comments
  • For helical, 1mm / 0.8mm for MPRs (trauma)

13
Post processing
  • MPR
  • Coronal and or sagittal reformations for trauma.
  • 3Ds
  • if required?

14
Filming
  • Format
  • 20
  • Window width and window level
  • 350ww / 40wl
  • Window width and window level
  • bone

15
Cervical SpineAxial
16
Anteroposterior Scout
17
Lateral Scout
18
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19
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20
  • Cervical spine
  • soft tissue

21
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22
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23
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24
Computed Tomography of Thoracic Spine
25
CT Thoracic Spine
  • Thoracic spine
  • Fine slices
  • MPRs

26
Indications
  • When thinking about indications for any CT, try
    thinking about what anatomy is located within the
    region being demonstrated.
  • It is important to know where you will be
    scanning
  • CT Thoracic Spine!
  • Anatomy?
  • What can go wrong?
  • Where are the most common pathologies

27
Indications
  • Thoracic Spine
  • Trauma
  • Pain in Thoracic region

28
Contraindications
  • Contraindications
  • NO previous plain films.

29
Patient preparation
  • Patient changed into radiolucent gown
  • Artifacts removed (as per cervical spine)
  • Necklace
  • Bra
  • Piercings (if possible)
  • Anything in shirt pockets

30
Scan parameters
  • Scan type
  • Axial
  • Helical (for trauma)
  • Anteroposterior and lateral scout
  • Coverage
  • Entire thoracic spine
  • From above to below region of interest
  • Comments
  • Angle parallel to disc space

31
Scan technique
  • Patient supine
  • Feet first
  • Arms raised above head
  • Anatomical landmark
  • Sternal Notch
  • Patient midline

32
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33
Coverage
  • Superiorly
  • From 7th cervical vertebra
  • Inferiorly
  • To 1st lumbar vertebra
  • For region specific
  • Above region of interest to below region of
    interest

34
Image reconstruction
  • 1st reconstruction
  • 3mm/3mm (soft tissue)
  • 2nd reconstruction
  • 3mm / 3mm (bone)
  • Comments
  • For helical, 1mm / 0.8mm for MPRs (trauma)

35
Post processing
  • MPR
  • Coronal and or sagittal reformations for trauma.
  • 3Ds
  • if required?

36
Filming
  • Format
  • 20
  • Window width and window level
  • 350ww / 40wl
  • Window width and window level
  • 2500ww / 500wl

37
Thoracic Spine
38
Lateral scout
39
Lateral scout
40
Sagittal Thoracic SpineBone window
41
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42
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43
Computed Tomography of Lumbar Spine
44
CT Lumbar Spine
  • Lumbar spine
  • Fine slices
  • MPRs

45
Indications
  • When thinking about indications for any CT, try
    thinking about what anatomy is located within the
    region being demonstrated.
  • It is important to know where you will be
    scanning
  • CT Lumbar Spine!
  • Anatomy?
  • What can go wrong?
  • Where are the most common pathologies

46
Indications
  • Lumbar Spine
  • Trauma
  • Pain in Lumbar region
  • Sciatica
  • Sponylolisthesis
  • Inter-vertebral disc anomalies
  • Disc herniation
  • Prolapsed Disc
  • Air in disc

47
Contraindications
  • Contraindications
  • NO previous plain films.

48
Patient preparation
  • Patient changed into radiolucent gown
  • Artifacts removed (as per cervical spine)
  • Bra
  • Piercings (if possible)
  • Jeans
  • Belts
  • Any metallic foreign object

49
Scan parameters
  • Scan type
  • Axial
  • Helical (for trauma)
  • Anteroposterior and lateral scout
  • Coverage
  • Entire lumbar spine
  • From above to below region of interest
  • Comments
  • Angle parallel to disc space

50
Scan technique
  • Patient supine
  • Feet first
  • Arms raised above head
  • Anatomical landmark
  • Iliac crests
  • Or Xyphoid process
  • Patient midline

51
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52
Coverage
  • Superiorly
  • From 12th thoracic vertebra
  • Inferiorly
  • To midway through sacrum
  • For region specific
  • Above region of interest to below region of
    interest

53
Image reconstruction
  • 1st reconstruction
  • 3mm/3mm (soft tissue)
  • 2nd reconstruction
  • 3mm / 3mm (bone)
  • Comments
  • For helical, 1mm / 0.8mm for MPRs (trauma)

54
Post processing
  • MPR
  • Coronal and or sagittal reformations for trauma.
  • 3Ds
  • if required?

55
Filming
  • Format
  • 20
  • Window width and window level
  • 350ww / 40wl
  • Window width and window level
  • 2500ww / 500wl

56
Lumbar Spine
57
Anteroposterior Scout
58
Anteroposterior Scout
59
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60
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61
Lumbar spine Axial
62
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63
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64
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65
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66
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67
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68
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69
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70
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71
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72
Trauma images
73
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74
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75
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76
Computed Tomography of Sacro-iliac joints
77
CT Lumbar Spine
  • Sacro-iliac joints
  • Fine slices
  • MPRs

78
Indications
  • When thinking about indications for any CT, try
    thinking about what anatomy is located within the
    region being demonstrated.
  • It is important to know where you will be
    scanning
  • CT Sacro-iliac!
  • Anatomy?
  • What can go wrong?
  • Where are the most common pathologies

79
Indications
  • SIJs
  • Trauma
  • Pain in Sacro-iliac joints

80
Contraindications
  • Contraindications
  • NO previous plain films.

81
Patient preparation
  • Patient changed into radiolucent gown
  • Artifacts removed (as per Lumbar spine)
  • Jeans
  • Belts
  • Any metallic foreign object

82
Scan parameters
  • Scan type
  • Axial
  • Helical (for trauma)
  • Anteroposterior and lateral scout
  • Coverage
  • 5th Lumbar vertebra
  • To mid-sacrum
  • Comments
  • Angle parallel to SIJs

83
Scan technique
  • Patient supine
  • Feet first
  • Arms raised above head
  • Anatomical landmark
  • Iliac crests
  • Patient Mid-sagittal plane

84
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85
Coverage
  • Superiorly
  • From 5th lumbar vertebra
  • Inferiorly
  • To midway through sacrum

86
Image reconstruction
  • 1st reconstruction
  • 3mm/3mm (bone)
  • Comments
  • For helical, 1mm / 0.8mm for MPRs (trauma)

87
Post processing
  • MPR
  • Coronal reformations if required

88
Filming
  • Format
  • 20
  • Window width and window level
  • 2500ww / 500wl

89
Sacro-iliac joints
90
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