Cardiac CT Scan Protocol: Comprehensive Guide for Clinical Practice

Pre-Procedure Requirements

Patient Preparation

• NPO for 4-6 hours prior to examination
• Remove all metallic objects
• Verify absence of contraindications
• Check renal function (eGFR)
• Obtain informed consent

Equipment Setup

• 64-slice CT scanner minimum
• ECG monitoring equipment
• Contrast injector
• Emergency cart availability

Scanning Protocol

Initial Steps

1. Position patient supine, head-first
2. Apply ECG leads
3. Establish IV access (18-20G)
4. Set breathing instructions

Technical Parameters

• Scan Type: Prospective ECG-gated
• Slice Thickness: 0.5-0.625mm
• Rotation Time: ≤350ms
• kV: 100-120 (BMI-based)
• mA: Auto-modulation
• Scan Range: Carina to diaphragm

Contrast Administration

1. Test Bolus:

   • 15-20mL contrast
   • 20mL saline flush
   • ROI in ascending aorta

2. Main Scan:

   • 50-80mL contrast (weight-based)
   • Flow rate: 4-6mL/sec
   • 40mL saline chase

Image Reconstruction

Standard Reconstructions

• 0.5-0.75mm slice thickness
• 0.4-0.5mm increment
• Multiple cardiac phases (systole/diastole)

Additional Views

• MIP reconstructions
• Curved MPR
• 3D volume rendering

Quality Control

Critical Review Points

• Motion artifacts
• Contrast timing
• Coverage completeness
• Image noise assessment

Documentation Requirements

Essential Elements

1. Contrast amount/type
2. Technical parameters
3. Radiation dose (DLP)
4. Any adverse events
5. Post-procedure instructions

Safety Considerations

Radiation Protection

• Use dose modulation
• Shield radiosensitive organs
• Document exposure parameters

Emergency Preparedness

• Contrast reaction protocol
• Emergency medication access
• Staff training verification