Anatomy of Adrenal Gland
Image taken from Microbe Notes
Appearance of Adrenal Gland in Axial CT Image
Right Adrenal Gland
Left Adrenal Gland
Protocol Structure
00_Liver3Phase (Adult)
- Topogram
- Non Contrast (full abdomen)
Contrast
- Adrenal
- (cover adrenal and kidney)
- Portal Venous Phase
- (full abdomen)
- Delayed 15 Minutes
- (cover adrenal and kidney)
Topogram
- Position the patient in head first supine position.
- Align the patient in Mid-Sagittal plane of the table.
- Position the transverse laser light beam at the level of patient’s nipple line to start the abdominal topogram.
Topogram Parameters
- Topogram length: 512 cm
- Slice: 0.6 mm
- Scanning direction: Craniocoudal
- Tube position: Top
- Stop the topogram scanning when the scanning reach / pass over the inferior ischial ramus.
Non Contrast
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level of mid heart
- Set the bottom line at the level of inferior ischial ramus.
- Ensure the lateral line to cover patient’s body outline.
- Remind the patient before scanning as the breathing instruction will be given.
Scanning Parameters
- kVp:
- mAs: Tube Current Modulation (TCM)
- Scanning Direction: Craniocaudal
- Scan Delay: 4 s
- Slice:
- Image Comment:
- Pitch:
Reconstruction of Non Contrast
Contrast
Type of contrast used:
- Non-ionic iodinated contrast media
- 300 I mg/mol
Needle Placement Test:
- Flow Rate: 3.5 ml/sec
- Volume of Normal Saline: 15 ml
Contrast Injection:
- Volume of Contrast Media: 100 ml (depend on patient’s body habitus)
- Volume of Normal Saline: 50 ml
- Method of injection: Contrast Injector
- Flow Rate:
- Contrast: 3.0 ml/sec
- Normal Saline: 3.0 ml/sec
Post Contrast Scan Planning
Adrenal
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level of mid heart
- Set the bottom line at the level below the kidneys.
- Ensure the lateral line to cover patient’s body outline.
Portal Venous Phase
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level of mid heart
- Set the bottom line at the level of inferior ischial ramus.
- Ensure the lateral line to cover patient’s body outline.
- Remind the patient before scanning as the breathing instruction will be given.
Examination Overview
Reconstruction of Adrenal
Reconstruction of Portal Venous Phase
Delayed 15 Minutes
- Plan the Scan FOV (SFOV) box at topogram image
- Set the top line at the level of mid heart
- Set the bottom line at the level below the kidneys.
- Ensure the lateral line to cover patient’s body outline.
- Remind the patient before scanning as the breathing instruction will be given.
Multiplanar Reconstruction (MPR)
Coronal Portal Venous Phase
- Image Thickness: 3.0 mm
- Number of Image: 19
- Coverage: Anterior to Posterior of abdomen
Series of Images Send to PACS
- Topogram
- Non Contrast 5.0 B30f
- Non Contrast 1.0 B20f
- Adrenal 5.0 B30f
- Adrenal 1.0 B20f
- PVP 5.0 B30f
- PVP 1.0 B20f
- Delayed 15 Min 5.0 B30f
- Delayed 15 Min 1.0 B20f
- Patient Protocol
- COR ST PVP
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