Specific anatomic region Adrenal
Application Evaluate incidentaloma
Author Elliot K Fishman, MD
Reference Source JHU Protocol
Scanner Used Siemens Sensation 64
KV/Effective mAs/ Rotation time (sec) 120 / 250/ 0.5
Detector Collimation (mm) 0.6
Slice thickness (mm) 1- 3mm
Pitch 0.75
Kernel 30
Reconstruction interval 1-3mm
Image order (acquisition) Cr-ca
Oral contrast 1000 cc water
IV contrast volume and type Non contrast first and then IV if needed (see below)
Injection rate 3-cc/sec (if used)
Scan delay (sec) For contrast 30 sec- 15 minutes
3D technique used Not routinely needed
Comment:
1. Do a noncontrast CT first and if attenuation under 10Hu and it is 4 cm or less it is an adenoma and you can stop. 2. If above 20Hu you can inject 100 cc of contrast and look at the washout value (check Hu at 1 minute and then at 5 thru 15 minutes to look for a 50% washout value).