HD(Hemodialysis )案例之 Abdomen做法

CAPD之病患 ,懷疑有 Leakage時 ,由腎臟科醫師執行打入 60ml Contrast Agent (Ominipaque 350mgI/ml)加 1500ml Dialysate(滲透液 )

經過 30分鐘再掃描 Abdomen Survey

Hip DDH

• Topogram: Laser Line對準 Iliac CrestSupine Position,通常不需加造影劑

• Note:• 1.運用 Thin Slice 2/1.4作MPR O-coronal2/2和 O-sagitt

al2/2及 Axial 2/2 與 SSD• 2.DDH(Developmental Dysplasia of Hip)髖骨發育不良開刀的幼兒 ,

• 切記 !只需要 Scan Hip Only.(dose!!)

Protocol Range Slice CollSli Increment Kernel Indication

DDH Topogram 1 T80s

PelvisRoutine 1 0.75 1 B31f

1 0.7 B31f

Cholangiography

• 20G Jelco Elbow

• 喝水 Distension

• Buscopan IV 1Amp

• Dicubitus Right Side 5-10min

Post Angiogram

• 梁主任 case

• Catheter直達 Liver

• Scan Liver Only

• 0.5ml/s 打 15sec 共 7.5ml

• Scan Start Delay:10sec

CTV

• 130ml Contrast Agent

• 2.5ml/s

• Scan Start Delay:3min

• Range: DiaphragmPubic Symphysis

(視臨床要看那一個部位 ,主要是 Abdomen)

Indication:1.Vetebral Plasy2.IVC Lesion 3.Low Limb DVT(Deep Vein Thrombosis)

Subclavian Artery Occlusion

• 利用 Aorta Chest做法• 由 Neck切至 Diaphragm• 20 jelco要 on腳上• Trigger ROI at Aorta Lumen• Threshold:100HU• 雙手擺身體兩旁• 使用 0.75mm Collimator• 組 5/5,1/0.7各一組影像 .

T-M joint Routine

Pre-CM: AXL 2/2(Bilateral)

Post-CM:AXL 2/2(Bilateral)Close&Open

Month,兩邊分開作MPR,SSD

Shoulder下之 Soft Tissue mass(R/O hemangioma)之做法 :

• 1.ShoulderSpiral Protocol2.ROI at Descending Aorta3.分為 3Phase:

• a.Artery Phase b.Capillary Phase c.Venous Phase* .Capillary Phase 是為了避免 A-Phase太早 ,產生 CM未達mass內之 Images

CTA,Low Limb

• 20’Jelco,On Elbow

• 100-120ml Contrast Agent,Rate:3-3.5ml/s

• ROI at L5 Level Aorta

• Threshold:100-120H.U

ROI at L5 Aorta

右側的動脈比左側的動脈相對明顯

Coronal View

3D Display

比較清楚發現左側小腿有明顯 Occlusion