2.  Pelvic CT.  Indications.  Contraindications.  Pelvic CT protocols. - Truma protocol. - Pathology protocol.  Patient after care.

3. It is an imaging method that uses x-rays to create cross-sectional pictures of the organs inside the pelvis (bladder, prostate, lymph nodes and pelvic bones).

4.  Pelvic truma or fracture.  Hematuria or suspected renal calculus.  Hematoma.  Suspected hemorrhage.  Hip osteonecrosis.  Ischemic bowel.  Pelvic inflammatory or infection disease(abscess/colitis).  Pelvic vein thrombosis.  Congenital abnormalities e.g. CHD.  Tumors, suspected or known (Lymphadenopathy/Primary or metastatic malignancies) CHD Ewing sarcoma osteosarcoma of the ilium

5. There are no absolute contraindications to pelvic CT examinations, the relative benefits should be outweigh the exposure risk. Check the following conditions : –ALLERGIES, ASTHMA, DIABETIES, KIDNEY DISEASE Ask if a patient is PREGNANT. Ask about prior reaction to contrast.

7. Truma protocol (C-) E.g. to rule out fractures or history of truma. Patient preparation : No need for pt. preparation since he comes directly from the ER. - Pt. should be stable (vital sings). - On stretcher. -No need to be NPO except if a sedation is needed ( NPO for 3-4 hrs). Patient position : -Supine. -Feet first in gantry. -Hands above the head.

8. -The vertical center is in the middle of the pelvis. -The axial center is in the iliac crest.

9. Type of recons. DFOVSFOVmAK.VEnd locat. Start locat. SpaceThicknessType of scan Standard 30 – 50 cm The size of the Pt. M,L The size of the Pt. Auto mA 200 - 400 120Mid of thigh. L42.5 5 Helical Standard window Bone window 2 nd reconstruction Bone window fractures.

10. - When the scan is end we can have 2D reformats (coronal, sagittal ) and 3D pelvis.

11. pathology protocol (C+) E.g. Ca ovarian, mass or swelling Patient preparation : - 60 ml castor oil the night before the procedure. - NPO from mid night. - The patient should be in department 2hrs before start the procedure. - check that pt. not allergic or asthmatic. - Check pt. renal function test ; for inpatient 1 week outpatient (diabetic) 3 months outpatient (non-diabetic) 6 months - Pt. is given the oral contrast gastrografin or telebrix 3% (30 ml in 1000 ml of water ), one cup every 10 min.

14. Type of recons. DFOVSFOVmAK.VEnd locat. Start locat. SpaceThicknessType of scan Standard 30 – 50 cm The size of the Pt. M,L The size of the Pt. Auto mA 200 - 400 120 Pubic bone. Mid of the chest 5 5 Helical 2 nd reconstruction 1.25 × 1.25 For reformat only.

16. showing a large filling defect (mass) extending posteriorly (arrows).

17. (C) Coronal CT reformat shows fluid-filled diverticulum (arrow). (D) Sagittal CT reformat shows a diverticulum descending from the inferior border of the small bowel (arrow). CT axial images with oral and intravenous contrast. A fluid filled diverticulum.

18. -The site of contrast injection will be bandaged. -The technologist will continue to watch the patient for possible adverse contrast reactions. -Pt. can eat or drink as normal. - If the Pt. inject with contrast, he/she should drink plenty of liquid to help flush it out from there system.