SPHP Radiology Protocols

INDICATIONS: GI bleed, bright red blood per rectum, hematochezia, melena

SERIES

	PRECONTRAST	LATE ARTERIAL	PORTAL VENOUS
POSITIONING/MODE	supine/helical	supine/helical	supine/helical
kV/mA/rot time	per scanner protocol CareDose/iDose/ASIR Care kV 120 to 140 kVp </= 1 sec	per scanner protocol CareDose/iDose/ASIR Care kV 120 to 140 kVp </= 1 sec	per scanner protocol CareDose/iDose/ASIR Care kV 120 to 140 kVp </= 1 sec
SLICE THICKNESS	3mm	3mm	3mm
PITCH	0.6 to 1.0	0.6 to 1.0	0.6 to 1.0
KERNAL	std	std	std
SFOV	300 mm	300 m	300 m
COVERAGE	diaphragm->pubic sym	diaphragm->pubic sym	diaphragm->pubic sym
ACQUISITION	craniocaudal	craniocaudal	craniocaudal
ORAL CONTRAST	None or volumen*	None or volumen*	None or volumen*
IV CONTRAST	None	100 mL Isovue 300 30 mL saline	yes
INJECTION RATE	---	4 mL/sec	---
SCAN DELAY	---	arterial phase bolus tracking aorta (80HU)	30 sec after arterial phase ~75 sec after injection
RESPIRATION	Inspiration	Inspiration	Inspiration
POSTPROCESSING	3mm Cor and Sag	3mm Cor and Sag	3mm Cor and Sag

NOTES: Give water (not oral contrast) 1-2 cups just prior to scanning the patient in order to distend the stomach.

For an acute lower GI bleed, it is important to scan the patient while the patient is still bleeding. As such, no oral preparation is performed.

For an occult GI bleed, an oral preparation with a negative oral contrast (Volumen) may be helpful.