CT Scan Brain – Head W / WO

CT Scan Brain - Head with and without CT

CT Scan Brain – Learn how to perform a head with and without contrast – some of these instructions may vary depending on the equipment you are working on or your facility protocols.

CT Scan Brain - Virtual CT Trainer Software

CT Scan Brain – Scanning the Head With and Without Contrast

CT Training Program – Head with and without contrast CT images are screen shots from the Virtual CT Trainer Software causing some degrading in the image quality.

Head Without Contrast

Exam Prep:

  • When preparing for a head CT, attach the head unit and position the patient supine and head first in the scanner
  • If it is a head with and without contrast – Draw up contrast – Start an IV if not already placed – Attach the IV line to the contrast line
CT Scan Brain - Head with and without contrast computed tomography 1

CT Scan Brain – Positioning the Patient:

  • Move the patient into the scanner until the positioning light is at the level of the chin. NOTE: This may vary depending on how the protocol at your facility is set up, but the level of the chin is common.
  • Adjust the table height until the horizontal light is just in front of the EAM as seen below.
  • Turn off the positioning light
CT Scan Brain - Head with and without contrast computed tomography 2
CT Scan Brain - Head with and without contrast computed tomography 3

CT Scan Brain – Scanning Scout Images:

  • When the patient is properly positioned in the CT gantry – Press the confirm button
  • Prep the scanner (Scan button will be solid or a flashing light – depends on manufacture)
  • Scan your AP & Lateral scout images – Some manufacturers will require the patient to move back into the gantry to scan the second scout and some will move the patient back into the scanner as it acquires the second scout.
CT Scan Brain - Head with and without contrast computed tomography 4

Adjusting Your Lines or Box to Cover Desired Anatomy:

  • Adjust the lines or box to cover from the base of the skull to the vertex of the head (lines or box depends on CT manufacture).
  • When scanning the head, angle your lines or box to match the angle of the skull base.
  • NOTE: Angling the gantry may vary at your facility. Some facilities don’t set it up with an angle in the protocol to save time. The theory behind the angle is reduce the direct radiation exposure to the eyes. The lined images below show with and without an angle. NOTE: When an angle is applied to the positioning lines or box, the scanner gantry will have to be angled to match the line angle.
  • When the lines or box are positioned over the desired anatomy, press the confirm button.
CT Scan Brain - Head with and without contrast computed tomography 5
CT Scan Brain - Head with and without contrast computed tomography 6

CT Scan Brain – Scanning the Patient Without Contrast:

  • After the scan parameters are confirmed, the scanner will require you to angle the gantry to match the angle that was placed (if an angle was used) on your lines or box when they were initially set up on your scout images.
  • Scan the head without contrast.
  • NOTE: If performing a head CT with contrast, you will always do a pre contrast scan prior to injecting the patient.
CT Scan Brain - Head with and without contrast computed tomography 7
CT Scan Brain - Head with and without contrast computed tomography 8

CT Scan Brain – Completing the Head Without Contrast:

  • Look through your images to verify you have all of the required anatomy.
  • If you are performing a head without contrast only, the scan is complete. Help the patient off of the scanner table.

Head With Contrast

If you are performing a contrast enhanced CT of the head, an IV will need to be placed. NOTE: Remember to do the contrast questionnaire looking for any contraindications and verify the patient’s labs before injecting contrast.

  • Move the patient back into the same start position as the non-contrast CT of the head and start the injection.
  • When scanning a brain CT with contrast, a scan delay of 4 to 5 minutes post injection is not uncommon. This delay gives the contrast time to cross the blood-brain barrier before the scan is performed (see your facility protocol).
  • Scan the head with contrast after the proper delay per your protocol.
CT Scan Brain - Head with and without contrast computed tomography 9
CT Scan Brain - Head with and without contrast computed tomography 10

CT Scan Brain – Completing the Head With Contrast:

  • Look through your images to verify you have all of the needed anatomy for the contrast enhanced head. Remove the IV if placed by you and help the patient off of the scanner table.
CT Scan Brain - Free Virtual CT Trainer Software

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Source of Header Image – https://commons.wikimedia.org/wiki/File:CT_of_a_normal_brain,_sagittal_22.png

Clipped off axial reference on right side