/clinical/,/clinical/references/,/clinical/references/orders/,/clinical/references/orders/ct-cta-order/,

/clinical/references/orders/ct-cta-order/

201411314

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UWHC,

Patient Care,

Clinical Hub,References,Radiology Order Guidelines

CT-CTA Order Guidelines

CT-CTA Order Guidelines - Clinical Hub, References, Radiology Order Guidelines

Focus

CT Head

IndicationExaminationComments
Trauma, headache, temporal bone CT head without contrast  
Primary or metastatic tumor CT head without and with contrast  
Infection CT head without and with contrast  
Possible sinusitis or polyps CT sinus without contrast  
Stroke evaluation CT head with and without contrast, CTA Head, CTA neck  

CT Sinus

IndicationExaminationComments
Possible sinusitis or polyps CT sinus without contrast CT sinus with and without contrast is rarely indicated

CT Maxillofacial

IndicationExaminationComments
Facial, orbital or mandibular trauma CT maxifacial without contrast CT maxillofacial with and without contrast is rarely indicated

CT Orbit

IndicationExaminationComments
Globe and orbital nerve pathology CT orbit with contrast  

CT Neck

IndicationExaminationComments
Infection, lymphadenopathy, head/neck cancer CT neck with contrast A CT head is not required
Assess vertebrae, nerve root, and spinal canal in patients with neck pain or radiculopathy CT cervical spine without contrast  

CT Chest

IndicationExaminationComments
Lung nodules or interstitial lung disease CT chest without contrast  
IV contrast allergiey (not premedicated) CT chest without contrast  
Interstitial lung disease CT chest without contrast  
Superdimension bronchoscopy planning CT chest without contrast  
Lung cancer or mediastinal masses CT chest with contrast   
Pleural and chest wall pathologies CT chest with contrast  
Acute chest trauma CTA chest  

CT Spine (CT C spine, CT L spine, CT T spine)

IndicationExaminationComments
Trauma, back pain, or radiculopathy CT spine without contrast  
Primary or metastatic tumor or infection CT spine without and with contrast  
Infection CT spine without and with contrast  
Postoperative lumbar spine CT lumbar spine without and with contrast  

CT Abdomen and Pelvis

IndicationExaminationComments
Urinary track calculus CT Flank Pain It is performed without contrast 
Hematuria CT Urography  
Adrenal adenoma, pancreas or kidney neoplasm screening CT abdomen without and with contrast  
All other indications CT Abdomen and Pelvis with contrast Always request a CT pelvis with CT abdomen unless evaluating for abnormality isolated to liver, spleen, pancreas or kidney.

CT 3D Reconstruction

IndicationExaminationComments
Indicate why 3D study is needed in addition to 2D CT CT 3D Need to indicate which body part

CT Bony Pelvis

IndicationExaminationComments
Infection, soft tissue mass or synovitis CT bony pelvis with contrast If the patient can have an MR, then MRI with and without IV contrast is superior to CT for these indications
All others CT bony pelvis ithout contrast  

CT Extremity (shoulder, humerus, elbow, forearm, wrist, hand, hip, thigh, knee, tibia-fibula, ankle, and foot)

IndicationExaminationComments
Infection, soft tissue mass or synovitis CT with contrast of specific body part If the patient can have an MR, then MRI with and without IV contrast is superior to CT for these indications
All others CT without contrast of specific body part  
Abnormality localized within the hip joint itself CT hip Order CT bony pelvis if pain is not definitely localized within the hip joint

CT Angio Chest for PE

IndicationExaminationComments
Possible PE CTA chest for PE If patient is less than 40 years old and has no contraindications to MRI, consider Chest MRA to avoid CT radiation. Exam and breath-hold time is similar to CTA

CT Angio Chest

IndicationExaminationComments
Suspected aneurysm, dissection or acute vascular injury CTA Chest If strong suspicion for PE, order CTA Chest PE

CT Angio Abdomen, CT Angio Pelvis

IndicationExaminationComments
Initial assessment or monitoring of aortic aneurysm Order CTA of abdomen and pelvis
Order CT without contrast of abdomen and pelvis
Also need CT without contrast of abdomen or pelvis to identify intramural and periaortic thrombus.
Surgical or endovascular repair planning   Indicate in comments "pre-repair 3D measurements needed"
Follow-up for aneurysm repair   Indicate in comment whether repair was surgical or endovascular stent-graft and whether this is the first post-repair CTA