IMAGING NON-‐OBSTETRIC EMERGENCIES IN PREGNANT PATIENTS
CT Abd-‐Pel Fetal Dose Range is approximately 15-‐30 mGy
Use lead shielding over abdomen & pelvis only for Head, Neck or Chest CT
Technique for Abdominal & Pelvic CT:
SCANNER Detector Config kVp Noise Index / Ref mAs
Routine CT mA Range Noise Index / Ref mAs Stone CT mA Range ASIR SAFIRE Pitch Rot Time
(sec) GE-‐16 16 x 1.25 120 18 (@ 5.0 mm) 100-‐360 22 (@ 5.0 mm) 50-‐300 N/A N/A 1.38 0.6 GE-‐64 64 x 0.62 120 40 (@ 1.25 mm) 100-‐360 48 (@ 1.25 mm) 50-‐300 70% (5 mm) N/A 0.98 0.5 Siemens 64 24 x 1.2 120 140 N/A 100 N/A N/A Strength 2 0.8 0.5 Siemens 128 32 x 1.2 120 140 N/A 100 N/A N/A Strength 2 0.8 0.5
All abdominal CT’s should only be single phase scans
Avoid scanning unnecessary territory
Acute Abdomino-Pelvic Syndromes
Acute Abdomino-Pelvic Pain
(without localization)
US Abd-Pel or
CT Abd-Pel w/ Contrast
Suspected Ureteral Stone
US of Kidneys & Bladder (include resistive indices &
ureteral jets)
CT Abd-Pel w/o Contrast
Suspected Appendicitis
US of Right Lower
Quadrant
MR of Right Lower
Quadrant
CT Abd-Pel w/ Contrast
If still inconclusive or suboptimal MR or
contraindication to MR
Fever of Unknown
Origin (localizing signs to abdomen or
pelvis)
US Abd-Pel
or CT Abd-Pel w/ Contrast
Suspected Cholecystitis
US of Right Upper Quad
HIDA
Suspected Pancreatitis
Lab Tests
CT Abd Only w/ Contrast
Suspected Bowel
Obstruction
Supine Radiograph Abdomen
MR Abd/Pel or
CT Abd-Pel w/ IV & Oral Contrast
(3 hr PO Prep) No delayed scan
Suspected Ovarian Torsion
US of Pelvis
Suspected Ruptured Splenic
Aneurysm
CTA Abd-Pel
Trauma
Fast Scan US
CT Abd-Pel w/ Contrast
(No Delays) Plain film at 15-30 min. if collecting system injury is
suspected
Conventional Cystogram if
bladder injury is suspected
IMAGING NON-‐OBSTETRIC EMERGENCIES IN PREGNANT PATIENTS
Contrast Volume for all CT exams: 100 ml only Ramit Lamba, MD; Director of CT
Ver 1.4 May 21, 2014
Acute Neurologic Syndromes
Headache
CT Head w/o Contrast
Acute Infarct or HIE
CT Head w/o Contrast
MR Brain w/o Gad
Cranio-Facial Trauma
CT Head / Facial Bones
w/o Contrast
Vertebral Dissection
CTA Neck
C.Spine Trauma
C.Spine x-ray’s or CT C.Spine
w/o contrast
Cord Compression
MR Spine w/o Gad
Non-compressive Cordopathy
MR Spine w/o Gad
Siuns Thrombosis
CTA/V Head
Aneurysmal Rupture
CTA Head
Acute Chest Syndromes
Suspected Pulmonary Embolism
CTPA
Suspected Arotic Dissection
CTA Chest Real time review by Radiologist at
CT console No base scan
Extend to L-4 if dissection seen
Trauma
CTA Chest
Fever of Unknown Origin (localizing to chest)
CXR
CT Chest w/ Contrast
