It is done to detect and examine tumors, kidney stones, congenital anomalies, accumulation of fluid around kidney, etc. This article is intended to outline some general principles of protocol design. This line of stones is known as stein strasse or stone street in german. With advancements in technology, it is rapidly replacing many diagnostic radiographic procedures. Book club hot topic quicktakes covid19 and genitourinary cancers. Computed tomography ct has become the reference technique in medical imaging for. If your doctor ordered a ct scan without contrast, you can eat, drink and take your prescribed medications prior to your exam.
Image gently pediatric imaging image wisely adult imaging the purpose of these ct protocol pages is to provide a reference. The stone must still be in the ureteric orifice since if it was free in the lumen it would sink to the. Unenhanced ct parameters dedicated for imaging evaluation of urinary stone disease in our institution. Kub is often the first diagnostic scan conducted in cases of renal colic. Computed tomography ct scan or cat scan is a noninvasive diagnostic imaging procedure that uses a combination of xrays and computer technology to produce horizontal, or axial, images often called slices of the body. Ct enterography this protocol is for evaluation of the small bowel utilizing low attenuation oral contrast volumen. Abdomenpelvis no contrast abdomenpelvis iv contrast abdominalpelvis for renal stone no contrast chest3phase liverpelvis. Head ct scan when performing a head ct the patients head is positioned in the head holder for most of the head protocols. This is in accordance with the 2012 kimberley hospital rule khr, a management protocol which indicates that ct head scanning in patients with mhi and gcs scores of 1515 can safely be delayed. The critical access hospital establishes or adopts diagnostic computed tomography ct imaging protocols based on current standards of practice, which address key criteria including clinical. It is usually considered the initial imaging modality for suspected urolithiasis in an emergency setting 1 nb. Ct protocol management rush is an academic health system comprising rush university medical center, rush copley medical center and. Computed tomography of kidneys, ureters and bladder ct kub is a quick.
Kidneys, ureters and bladder kub envision medical imaging. Below are my top 10 reasons to think about when considering a ct in your next suspected renal colic patient. However, it is not clear how the use of ct kub at our hospital has changed since 2006, and we have anecdotally noticed an. The purpose of these ct protocol pages is to provide a reference for radiology residents, fellows and technologists when prescribing a ct examination. However, a recent study showed that in most imaging centers lowdose ct protocols were not used to diagnose renal colic 19. The true positive rate of ct kub for renal colic has decreased significantly. In full colour throughout, and with a free cd rom containing the 62 figures in the book, step by step ct scan is an excellent pocket reference for. Ct broadly refers to many types of imaging scans with differing. We are getting more negative scan results and more scans diagnosing other significant pathology. A noncontrasted computed tomography scan of the kidney, ureter, and. No oral prep for ct kub ro kidney stones chest npo nothing by mouth 4 hours before procedure except for medications. The computed tomography ct scan of kidney, ureter and bladder is a noninvasive imaging procedure done with the x ray beams. A new systematic approach for the imaging assessment of patients with chronic pancreatitis april 2020. Reduced radiation dose ct kub protocols are an effective imaging.
The primary purpose of this scan is to allow the radiologist to measure the angle of rotation of the femoral necks relative to the femoral condyles, bilaterally. Ge 64 routine chest ct scan type helical helical scan range apex to adrenals apex to adrenals rotation time 0. Alone, each test has its limitations but when the results of the scans are fused together they provide the most complete information on cancer cell function and location. Headneck npo four hours before procedure except for medications. Computed tomography ct scanning is an extremely common imaging modality in modern medicine. It uses a combination of xrays and a computer to create pictures of your organs, bones, and other tissues. In some procedures, iv contrast media may be injected. Computed tomography of the head uses a series of xrays in a ct scan of the head taken from many different directions.
A retrospective audit evaluating the radiation exposure during ct. Diagnostic accuracy of low and ultralow dose ct for identification. The volume contains a detailed technical section and covers the prevailing investigations of the brain, neck, lungs and chest, abdomen with parenchymal organs and gastrointestinal tract, the musculoskeletal system and cta as well as dedicated protocols for the heart. This handy to use pocket book provides the information necessary to manage a ct scan, covering all the topics involved, and also suggests guidelines for the planning of advanced ct studies. Kub nephrolithiasis stones, urolithiasis, flank pain and hematuria series 1 scan slice thickness 5 index 5 fov pt size algorithm std. Head ct scan procedure thursday, november 10, 2016. Ct angiography versus conventional angiography for the postoperative evaluation of clipped cerebral aneurysm april 2020. Xrays are made with the use of an external radiation apparatus to produce images of. The radiologist must use a lowdose ct protocol with preadjusted parameters. Salient points in kidney stone ct protocols kidney stone ct protocols should be done at reduced dose relative to routine abdomenpelvis scans. Since its inception, it has become a popular method of disease diagnosis. This scan is used to diagnose conditions of the urinary system, including kidney stones and. Emergency department imaging protocol for suspected acute.
Ct scan computed tomography cat scan centers and services. This will help filter your search to just protocols within that specific list. Computed tomography of kidneys, ureters and bladder ct kub is a quick noninvasive technique for diagnosis of urolithiasis. Top 10 reasons not to order a ct scan for suspected renal. Medical physicists partner with radiologists, technologists, regulators, manufacturers, administrators and others to ensure that ct scans are performed using the minimum amount of radiation required to obtain the diagnostic information for which the ct scan was ordered, or to guide the therapeutic procedure for which the ct is used. The authors believe clinicians thresholds for imaging may have decreased due to. A ct scan is a special xray test which generates crosssectional images of the body through the use of xrays and a computer. Aua 2019 concerns about radiation exposure with abdominal imaging, effort to help. For any given ct examination, the protocol will vary according the individual requirement of the imaging site. The purpose of these ct protocol pages is to provide a. Noncontrast ct in the evaluation of urinary tract stone obstruction. How to perform lowdose computed tomography for renal colic in. Value of prone ct in renal colic evaluation radiology.
If you know the machine type that the protocol you are looking for falls under, select that machine e. Computed tomography of kidneys, ureters and bladder ct kub is a quick noninvasive technique for diagnosis of stone disease. Kub and 3d reconstruction of stone protocol ct in patient status post lithotripsy or left staghorn calculus. Ct kub is not only extremely sensitive and specific in. An intravenous pyelogram ivp is a type of xray that looks at your kidneys and bladder and the ducts ureters that connect them. Actual protocol of ct kub for evaluation of stone disease and haematuria vary on. A ct scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.
Axial noncontrast images inverted so look like supine but note position of the table on the anterior abdominal wall. Emergency department imaging protocol for suspected acute renal. Ct scan patient prep west hernando diagnostic center. An overview of kidney stone imaging techniques ncbi. Scan the entire abdomen in this acquisition top of the liver to sp. The kub ct scan obtains the image of the urinary system from different angles. Gemstone spectral imaging dualenergy computed tomography. Ct protocols for common primary care diagnoses lacey j. Actual protocol of ct kub for evaluation of stone disease and haematuria vary on institutional guidelines. Ct stone protocol in sagittal oblique plane through the left kidney shows a parapelvic cyst. Computed tomography ctabdomen and pelvis, repeated with and without contrast material 20 msv 7 years computed tomography ctcolonography 6 msv 2 years intravenous pyelogram ivp 3 msv 1 year barium enema lower gi xray 8 msv 3 years upper gi study with barium 6 msv 2 years radiation dose in xray and ct exams page 2 of 5. Ct kub ct of the kidneys, ureters and bladder uses ct technology to take images of the kidneys, ureters and bladders.
Noncontrast ct in the evaluation of urinary tract stone. Noncontrast computed tomography ct abdomen has emerged as a first line. Indications for mri kidney ureters and bladder kub scan. Suspected bowel obstruction or gastrointestinal perforation. Check the positioning block in the other two planes. An appropriate angle must be given in the sagittal plane perpendicular to the lumbar spine. In patients with nephrolithiasis, noncontrast ct or ctkub radiography are. A computed tomography ct or cat scan allows doctors to see inside your body. Virtually all stones are radiopaque on ct, and stone size can be measured. Ct scan computed tomographycat scan centers and services.
Value of noncontrast ct examination of the urinary tract stone. Computed tomography ct or cat scan of the kidney johns. This was known as the conventional dose ct scan cdct and served as the reference standard in this investigation. Ct images of the head are used to investigate and diagnose brain injuries and other neurological conditions, as well as other conditions involving the skull or sinuses it. Urolithiasis appropriateness criteria american college of. Ct protocol monitoring and optimization joint commission standard pc. The first ct protocol, however, was designed to impart an effective dose of 8090 % of the effective dose of the standard departmental noncontrast ct scan of the urinary tract. An isolated ct scan is incredibly safe, but % of cancer is estimated to arise from medical imaging. Ct bone skull 3d ct bone ul limbs pelvis 3d ct all joints 3d ct chest.
Slice counts dual source, 320 slice, 256 slice, 128 slice, 64 slice, 16 slice, 4. Depending on the design of the head holder, this head holder it can sometimes also be used for neck protocols. To demonstrate the use of noncontrast ct examinations stone protocol in the detection of abdominal. The petct scan has the benefit of combining the pet scan information about cell function with the ct scan information about the size and shape of abnormal cells. Diabetic patients need to be off glucophage and glucovance 48 hours after the procedure.
In male patients, the prostate gland and seminal vesicles are also scanned. Ever since its introduction, computed tomography examination of the urinary system with no contrast. It is also known as cat or computerized axial tomography. Ct kub subsequently became the first choice in the diagnostic imaging of urinary tract for obstruction of stones. A metaanalysis on the effectiveness of multidetector ct for the diagnosis of small bowel obstruction. Slices must be sufficient to cover the whole abdomen and pelvis from. The initial experience with the new imaging protocol was reported in a study by chowdhury et al between february and october 2006, which demonstrated the efficacy of ct kub in the investigation and management of patients. Femoral anteversion page 1 of 2 indications for femoral anteversion aka ct scanogram, tibial torsion this is a very limited study. Standard imaging protocol, the anatomical scanning region of the kub starts at. Ct scanning ct protocols ct scan protocols imaging. Yet, in certain clinical scenarios, xrays of the abdomen kubs and ct scans.
Contrast oral no iv no scanning anatomical start top of liver anatomical stop symphysis inspiration yes filmingwindowing soft tissue yes. In children, abdominal xray is indicated in the acute setting. A renal or kidney protocol ct scan is done in 2 phases. Especially followup exams for kidney stones 30% lower dose than routine abdomenpelvis scan is a good target. First, we wanted to show how to use lowdose ct in patients with suspected renal colic in current clinical practice. Mcintosh do, mph university of massachusetts medical center. Ct kub scan cost in india range from rs 4000 to rs 7000. It was initially used in the evaluation of radiolucent stones only however, smith et al. There are stone fragments lining up in the distal ureter causing obstruction. The critical access hospital plans the patients care. Aapm ct scan protocols the alliance for quality computed. The indiscriminate use of ct kub in all female patients with flank pain should be avoided, and it is suggested that they should be initially evaluated with.
It is sometimes abbreviated to axr, or kub for kidneys, ureters, and urinary bladder. Ct scan protocols, ct protocols by manufacturer ge, siemens, phillips, toshiba. Factors that infl uence a specifi c sites protocol parameters include the type of equipment available e. This book provides structured uptodate information on all routine protocols used for multislice multidetector row ct. Abdominal xray will demonstrate most cases of bowel. In this article, we will outline the basic science behind ct scans, describe the principles of interpretation, and highlight their advantages and drawbacks compared to other imaging techniques. Kub is a diagnostic imaging xray technique to investigate organs and structures of the urinary and gastrointestinal tract. This scan is used to diagnose conditions of the urinary system, including kidney stones and causes of flank pain.
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