Protocols for Cardiac MR and CT by Guillem Pons-Lladó download in pdf, ePub, iPad
Delayed phase - minutes p. Anastomosis leakage Leakage after bowel surgery is a great clinical problem. Nephrogenic phase - sec p. In this table only specific protocols are summarized, since most institutions have their own standard protocols.
Early arterial phase - sec p. In most cases you also want to scan the whole abdomen. Use for instance a green venflon. We ask the patient to breath in normally and hold his breath to avoid the transient interruption of contrast, which will be explained in a moment. If this patient would have been given positive oral contrast, you probably would not have notice the ischemic bowel.
Here you don't want to be too early, because you want to load the liver with contrast and it takes time for contrast to get from the portal vein into the liver parenchyma. The coronal reconstruction nicely shows bowel wall enhancement in a patient with ileus due to a small bowel obstruction. Hypervascular lesion is best seen in late arterial phase. This tumor is best seen when the surrounding tissue enhances, i.
Liver Hypervascular tumor left enhances in late arterial phase. We prefer to scan from bottom to top, because if a patient can't hold his breath, then you will have less breathing artefacts in the lower lobes, where most of the emboli are located. Sometimes a lesion will be hypovascular compared to the normal tissue and in some cases a lesion will be hypervascular to the surrounding tissue in a certain phase of enhancement.
Oral contrast Some prefer to give positive oral contrast to mark the bowel. In the early arterial phase we nicely see the arteries, but we only see some irregular enhancement within the liver.
So a hypervascular tumor will be best seen in the late arterial phase. In aterial phase imaging the time window is narrow, since you have only limited time before the surrounding liver will start to enhance and obscure a hypervascular lesion.
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