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Rupal Jain
Resuscitationist interested in #MedEd and Emergency Radiology. Secret Superpower: x-ray vision, obvs. Other: Audiovisual learner enthusiastic about creating some audiovisual educational content
The Pre-brief
Let’s do some DOGmalysis for CATscansÂ
The Debrief:
- Pearl #1: Certain CT scans deliver more radiation to patients than others. Obtaining a CTA of the chest as opposed to a dry CT scan of the chest offers double the effective radiation dose. Similarly, a CT of the abdomen/pelvis with and without contrast delivers double the effective radiation dose of a single-phase CT of the abdomen/ pelvis.
- Pearl #2: CT with contrast should not obscure clinically significant ureteral stones. Just because the ureteral stone is on the differential, you do not have to order a CT both with and without contrast.
- Pearl #3: The indication to order a triple-phase CT is to better characterize liver lesions.
References
- Corwin MT, Lee JS, Fananapazir G, Wilson M, Lamba R. Detection of Renal Stones on Portal Venous Phase CT: Comparison of Thin Axial and Coronal Maximum-Intensity-Projection Images. American Journal of Roentgenology. 2016;207(6):1200-1204.Â
- Oliver JH, Baron RL. Helical biphasic contrast-enhanced CT of the liver: technique, indications, interpretation, and pitfalls. Radiology. 1996;201(1):1-14.
- Smith-Bindman R, Lipson J, Marcus R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. 2009;169(22):2078-2086
