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NIRC PROTOCOL FOR CT SCANNING GENERAL GUIDELINES ORAL CONTRAST Oral contrast is not utilized for abdomen and pelvic CT Angiography(CTA). Oral contrast is not utilized for abdomen and pelvic CT Urography. Oral contrast is necessary for most abdominal and pelvic imaging- including trauma. 900ml of oral contrast (in divided doses) should be given to the patient beginning one to two hours before the exam. Effervescent crystals are recommended to distend the stomach just prior to scanning (VERY important for upper abdominal pain and history of GE JXN tumor). Abdomen only scanning uses 450ml of oral contrast given to the patient one hour prior to the exam. Contrast media may be introduced thru a nasogastric tube if necessary. For imaging of suspected appendicitis, opacification of the cecum with contrast is required. If the patient is unable or unwilling to drink, then rectal contrast should be employed. If the referring physician wants to change the protocol, have them consult the radiologist prior to scanning. Insert a vaginal tampon for female or pelvic patients with indications of cervical, rectal cancer, or pelvic mass. Use good judgment for the very young and the very old. Revised 05-2009 1 There are four types of oral contrast: dilute barium (Readi-Cat), gastroview (water-soluble contrast), VoLumen (low attenuation for CT Enterography), and water. 1. Dilute Barium (Readi-Cat): used for all scheduled outpatients picking up their contrast in advance. 2. Gastroview (water- soluble contrast): used for inpatients, ER patients, surgical patients and all add-on patients (This is for faster transit and is considered safer with bowel perforation). 3. Water: an excellent oral contrast and will be used for imaging of the kidneys and pancreas. 4. VoLumen: (low attenuation for CT Enterography):used for patients with small bowel disease (Crohn’s) to better visualize the intestinal wall and lumen. In some cases we will use Enterography instead of performing a small bowel series Revised 05-2009 2