IAC CT Scan Parameter/Protocol Form

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15 Νοε 2013 (πριν από 3 χρόνια και 6 μήνες)

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CT Scan Parameter Form


1

Reviewed

8
/2012

IAC
CT
Scan Parameter/Protocol Form


Using the table below, i
ndicate the scan parameters and protocol used for each of the submitted cases using a
separate form for each case.



Type of study (i.e.
,

cardiovascular CTA,
head
,

etc.)
:











Patient
n
ame or ID
:






Patient
w
eight
:









CT
s
canner make and model
:







Maximum number of slices per acquisition for this unit
( 16, 64, 320, etc
.
)
:








Acquisition series
(include
all)

(i.e.,

axial, helical)































kVp/mA

and rotation time


or
kVp/
mAs































CTDI (vol)

required (
if on
system
)































Dose length product (DLP)

required if on system































Total dose per acquisition
and/or total dose per study
if available

in units given































Tube current modulation
or dose redu
ction
technique
(is used)































Anatomical Scan range

(i.e., dome of liver thru
pubic symphysis)































Increment

(space between
slices)
































Detector collimation (mm)































Slice thickness (mm)































Pitch or table feed































Scan FOV (cm)































Kernel/filter































Reformat technique

(i.e., 3D, plane/views)































Contrast type/rate

(if applicable)































Time from contrast injection
to image acquisition
,

if
applicable (sec)