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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