These 2 phases allow the differentiation between solid and cystic renal masses. Search across Medicare Manuals, Transmittals, and more. 70547. It has been reported that up to 66% more small renal masses are detected in the nephrographic phase compared with the corticomedullary phase. 'D]:iKv6"SJB^Dc{fmbxK7/T Dug1.r3hwL Prednisone: 50 mg PO (three doses total) to be taken 13 hours, 7 hours and 1 hour prior to appointment. Imaging is essential in renal mass characterization in order to guide appropriate treatment selections, because the management paradigm of localized renal tumors has evolved in recent years to include active surveillance and thermal ablation in addition to partial and radical nephrectomy. Similarly, precontrast CT also improves visualization of calcification ( Fig. An important component of adrenal MRI protocol is chemical shift imaging (CSI). Radiographics. How We Do It: Managing the Indeterminate Renal Mass with the MRI Clear This review focuses on the CT and MR imaging protocol selection and optimization for renal mass evaluation. Those that are homogeneous with HU greater than 70 are hemorrhagic or proteinaceous cysts ( Fig. 0000008946 00000 n HCC Renal Mass or Cyst Transitional Cell Carcinoma of Kidney Increased Liver . , For example, prior studies have shown that clear celltype RCCs demonstrate peak enhancement during the corticomedullary phase. MRI Abdomen with or without contrast 74183 Hematuria (blood in urine) Renal mass (cyst or solid) Transitional cell carcinoma of kidney Abnormal findings on other imaging studies Yes Body . 2004;24(2):e20. Similarly, on a single-phase postcontrast CT, renal masses that are homogeneous and measure fluid density are simple cysts. Do not start scan until the patient has stopped breathing. During this phase, there is intense enhancement of the renal cortex, allowing differentiation between the cortex and the medulla. Prep: Patient should not have caffeine 24 hours prior to exam; NPO 2 hours for all studies w/ contrast, Arrival time: 30 minutes prior to exam for registration and prep, Prep: NPO 2 hours for all studies w/ contrast, Prep: NPO 4 hours; may drink clear liquids up to 30 minutes prior to exam, CPT Code 72240 (Precert CPT Code 72240 & 72126), CPT Code 72255 (Precert CPT Code 72255 & 72129), CPT Code 72265 (Precert CPT Code 72265 & 72132), CPT Code 73700 (specify unilateral or bilateral), CPT Code 73701 (specify unilateral or bilateral). Kang S, Huang W, Pandharipande P, Chandarana H. Solid Renal Masses: What the Numbers Tell Us. codes. Check the positioning block in the other two planes. endobj (, CT in a 64-year-old man with a renal mass illustrating the utility of excretory phase in delineating involvement of the collecting system. PDF MRI renal mass protocol v1 - Abdominal Radiology . JN trailer <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R 15 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Plan the axial slices on the coronal plane; angle the position block parallel to the right and left renal pelvis. The suggested imaging protocols are based on expert consensus, with the goal of balancing diagnostic efficacy and radiation exposure ( Table1 ). Centre the laser beam localiser over the level of lower intercostal border (i.e. UB@&^v0c&]IG'#4-;j84j8BB"a6z2L0f#MG5ZP6l#AlX*k%rm9 R8XAe+S7"kTPPOA^vd@b/[wO;R}cH3@4B nMEz|pHj-ZBuQZr)AC6>*dZ3Yd'~AqClWIA{7^l!T Check the positioning block in the other two planes. View the CPT code's corresponding procedural code and DRG. GU PROTOCOLS: CT cystogram: BCT G01: 3 phase: nc.90sec.6min, Primary eval or post-op bladder canc: CT Cystogram (Trauma) - Filled only: 1 phase (filled) Evaluate for bladder injury, or follow-up of bladder injury (low-dose) Renal Mass 3 phase: BCT G02: 3 phase: nc.90sec.6min: Evaluate renal mass: Renal Donor 3 phase: BCT G04: 3 phase: nc.art . . (In our department we instruct the patients to breathe in and out twice before the breathe in and hold instruction. MRI renal mass protocol v1.0 Society of Abdominal Radiology Disease Focused Panel on Renal Cell Carcinoma Zhen Jane Wang, MD, Project Leader Matthew S. Davenport, MD, Co-Chair Stuart G. Silverman, MD, Co-Chair Hersh Chandarana, MD Ankur Doshi, MD Gary M. Israel, MD John R. Leyendecker, MD Ivan Pedrosa, MD, PhD Steve Raman, MD Erick M. Remer, MD 4 0 obj These are fast single shot localisers with under 25s acqusition time which are excellent for localising abdominal structures. zb;5X/Cac Zvq\H2w;w;/~Ne#)*7!nG (]vS~(HakGK Z6M5f?CS e <<9D26B84D59B5D04CBD15A8A60877983D>]/Prev 685671>> endstream endobj 45 0 obj <> endobj 46 0 obj <> endobj 47 0 obj <>stream <>>> 0000002341 00000 n Renal tumors are incidentally discovered at an increasing frequency due to the widespread use of cross-sectional imaging. 7 ). PDF Magnetic Resonance Imaging - Mri Magnetic Resonance Angiograhy - Mra 0000009557 00000 n hb```b``)a`e``ld`@ 4">kvv6*g^.i#wVz7_[/P=6w,t9ijtOT ~+IbInz/?^zPY\ w For example, papillary RCCs typically demonstrate low-level progressive enhancement, peaking at the nephrographic phase ( Fig. Arrive 90 minutes prior to exam for registration and prep. For some departments and/or radiologists, a renal mass protocol may only include a non-contrast, nephrogenic phase exam. Optimized imaging protocols enable analysis of imaging features that help narrow the differential diagnoses and guide management in patients with renal masses. Better depict the relationship between the collecting system and the mass. Not all exams are available at all locations. Position the patient over the spine coil and place the body coil over the abdomen (xiphoid process down to anterior superior iliac spine) Subscribe to Anesthesia Coder today. If possible provide a chaperone for claustrophobic patients (e.g. stream Ask the patient to undress and change into a hospital gown 2. Patient came in with rt foot pain and swel [b]MRI Extremity - Joint/Nonjoint[/b] Do not interleave images. 3 0 obj , When the initial CT is unable to provide a definitive diagnosis, subsequent multiphase renal protocol CT after IV contrast injection commonly is obtained for further characterization of a renal mass. 0000009361 00000 n endobj %PDF-1.3 % For active surveillance, postablation surveillance, or postpartial nephrectomy surveillance, precontrast and nephrographic phases should be obtained. Slices must be sufficient to cover both kidneys from two slices above the upper pole of kidney down to two slices below the lower pole of kidney. Consider not using SENSE and allowing wrap into the peripheral image, but not into the kidneys. Patient with renal insufficiency or hemodialysis; Rib mass/fracture (bony chest) Patient pregnant; MRA/MRV Chest w/ and w/o contrast . . Plan the axial slices on the coronal plane; angle the position block parallel to the right and left renal pelvis. (, Presurgical planning CT in a 65-year-old man with a left renal tumor. 2 B). For prepartial nephrectomy or preablation planning of renal masses that have been previously completely characterized, the primary goal is to delineate the tumor and vascular anatomy. On the other hand, the presence of intralesional calcification, regardless of the presence of fat, should prompt suspicion for malignancy, such as RCC. 0000000876 00000 n 6Mvw\Th_?\)&sEpka>yB" }T]),i7x7/:j]`)\AJ]%#-I> `-e$=nr&=>naj@r"0cTHaZegZ[lIi;Beh&/h]$Swt\' !uQ!FzRe?EjI-.'iJ~z]wN&:7W^Usn?pEl?dlMQ ?[?: ?L5tZD'UT]gUDoor This modality enables the radiologist to detect intra-tumor fat resulting in a loss of signal intensity. BODY PART REASON FOR EXAM PROCEDURE NOTES CPT CODE HEAD AND NECK Sella/Pituitary Pituitary dysfunction Adenoma, Sellar or suprasellar mass MRI HEAD W AND W/O CONTRAST (UMC order appears as MRI BRAIN W AND W/O CONTRAST) 70553 Inner Ear (IAC) CPA tumor It is most often comprised of a non-contrast, nephrogenic phase and excretory phase. An appropriate angle must be given in the sagittal plane (perpendicular to the long axis of kidney). The injection rate is suggested at 2 mL/s to 5mL/s. [U]Non-joint [/U]studies are to be We have a separate company with an MRI unit and we were approved by Medicare. p,PPD9DL{O,!s]7mV6Rlzu_aB[v RKov/ cardiac pacemaker, insulin pump biostimulator, neurostimulator, cochlear implant, and hearing aids) Planning must be done in the breath hold T1 vibe coronal because the diaphragm will push down the upper abdominal organs during inhalation and change the position of the kidneys from the initial localizer scans. Patients with anaphylaxis or laryngeal edema should be discussed with radiologist before the exam and/or premedication is ordered. The Society of Abdominal Radiology (SAR) Disease-Focused Panel (DFP) on RCC is a multi-institutional working group aimed at addressing the unmet needs in the clinical care, research, and education in RCCs. 11 The vast majority of asymptomatic adrenal masses are benign, and patients . The excretory phase may be helpful for distinguishing urothelial cancers from RCCs and parapelvic or peripelvic cysts from hydronephrosis and for diagnosing calyceal diverticula. non-contrast scan is best to determine the HU of homogenous renal mass or masses containing macroscopic fat 1, corticomedullary phase is best to delineate subcategories of renal cell carcinomas further, nephrogenic phase is best for optimal enhancement of the renal parenchyma, including the renal medulla, and will demonstrate enhancing components of a mass, excretory phase will demonstrate enhancement of calyces, renal pelvis and ureters. Chest w/o contrast (with 3D reconstructions), CTA Chest w/ contrast (with 3D reconstructions), EVT Abdomen Pelvis w/o contrast w/3D (with 3D reconstructions), Abdomen and Pelvis enterography w/ contrast, CTA Abdomen Pelvis (with 3D reconstructions), CTA EVT Chest Abdomen Pelvis w/o contrast w/3D (C) (with 3D reconstructions), CTA Chest Abdomen Pelvis (with 3D reconstructions), EVT Chest Abdomen Pelvis w/o contrast w/3D (C) (with 3D reconstructions), Urogram CT Abdomen and Pelvis w/ and w/o contrast w/3D reconstruction (with 3D reconstructions), Abdominal Aorta and Bilateral Iliofemoral Runoff (with 3D reconstructions), Internal Auditory Canal Cochlear Implant w/o contrast, CTA Head w/ and w/o contrast (with 3D reconstructions), CTA Head Neck w/ and w/o contrast (3D reconstructions), Arthrogram Shoulder (Arthrogram only; no IV contrast), Arthrogram Elbow (Arthrogram only; no IV contrast), Arthrogram Wrist (Arthrogram only; no IV contrast), Arthrogram Hip (Arthrogram only; no IV contrast), Arthrogram Knee (Arthrogram only; no IV contrast), Arthrogram Ankle (Arthrogram only; no IV contrast), Woodard to Lead Mallinckrodt Institute of Radiology, Sauk Named Interventional Radiology Chief, Miller-Thomas Receives Distinguished Service Teaching Award. The purpose of this exam is to assess the location and composition of a renal mass. 1 ) 99% of the time. 0000007963 00000 n Excretory phase is obtained at 7 minutes to 10minutes after IV contrast injection. Appt Reason CPT CodeCPT CodeCPT CodeCPT Code 11801 SW 90 Street Suite 102 Miami FL 33186 Tel: 305/270-6001 Fax: 305/270-6955 MRI Chest and Left Scapula W/O&W/Contrast 71552 73220 A9579 . % 0000031716 00000 n They vary widely in biological aggressiveness, ranging from benign tumors to high grade renal cell carcinomas (RCCs). The aim of this study is to investigate the feasibility of eliminating the nephrographic phase from the four-phase renal computed tomography (CT) imaging to a three-phase protocol without affecting its diagnostic value. <>/Metadata 1078 0 R/ViewerPreferences 1079 0 R>> PDF MRI ANATOMICAL GUIDE - Desert Medical Imaging Do not start scan until the patient has stopped breathing. Intracranial aneurysm clips (unless made of titanium) 2001-2023 Oregon Health & Science University. The MR sensitivity for adenomas measuring 10-20 HU is nearly 100%, while that for lipid-poor adenomas measuring greater than 30 HU is significantly lower (13 . Note: Instruct patient to arrive 45 minutes prior to exam for registration and prep. > For the assessment of cystic kidney disease endstream endobj 103 0 obj <>stream Trigger & track. By applying enhancement thresholds, 1 study has shown that 4-phase CT attenuation profiles enabled differentiation of clear cell RCCs from other solid renal cortical masses, notably from papillary RCCs and lipid-poor AMLs. Premedication Protocol. View any code changes for 2023 as well as historical information on code creation and revision. 2 AD). 'f2J}0y:[]m jB|+7)Hed6'BghE~1-&&y-:+qX$*4p:5Zt5_l^t}Zp@[?e[lI{'? ak+k)g3_%"-st*:@1LyrkzAK RbRY QpeWD4-g5EE9:K_tJ,s#ZxiBUo&9z(3>,m Nephrographic and excretory phases also are included, with the field of view expanded from diaphragm to iliac crest. CT Abdomen without contrast (CPT 74150) or CT Abdomen and Pelvis without contrast (CPT 74176) if there is renal insufficiency/failure, or a documented allergy to contrast. 6 ) or identify vascular anomalies, such as pseudoaneurysm and arteriovenous fistula. These include renal cysts, benign renal tumors, and renal cell carcinomas (RCCs) that have variable biological aggressiveness. (, CT in a 69-year-old man with a papillary RCC demonstrating improved enhancement assessment on the nephrographic phase compared with the corticomedullary phase. In order to optimally visualize the small foci of fat, thin sections (eg, 1.25mm) may be required. Explain the procedure to the patient %%EOF > carcinoma) Give a pillow under the head and cushions under the legs for extra comfort Premedication Protocol. ?,)NA The renal mass CT protocol is a multi-phasic contrast-enhanced examination for the assessment of renal masses. 0000003953 00000 n 0000011123 00000 n T2 tse breath hold (TRUFI or HASTE)coronal 4mm, Plan the coronal slices on the axial plane; angle the position block parallel to the mid line along the right and left kidneys. endstream endobj 98 0 obj <>]/Pages 89 0 R/Type/Catalog>> endobj 99 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[0.0 0.0 612.0 396.0]/Type/Page>> endobj 100 0 obj <> endobj 101 0 obj <>stream However, this article will cover the optional,corticomedullary phase too. Diagnostic Radiology (Diagnostic Imaging) Procedures, Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities, Copyright 2023. JJW1iXC2wH(5Rm>^'cxTI YDLN!{4]. m:8G1j NOx/4n O i8sp?X&{`Ec{qr%R2Tto]^8_gYQ*.Ivp+kZ1/z`y@"6}Y&$4Ps0kRu$!IQK1q{%zu4Pm?= ha^Vv&T(`(kqi!RXa&_$/6,YpCA=gbxhWfD7=X9nB[0\c?. 10 ). <> CPT ETO CYC DXR: Craniospinal (25.5 Gy) + Local (25.5 Gy) PDF 2020 CPT Code Exam Ordering Guide - Imaging Healthcare However, Medicare is denying CO-B7 billing under our podiatrist. CT protocols should be tailored to different clinical indications, balancing diagnostic accuracy and radiation exposure. The widespread use of cross-sectional imaging has led to a continuous increase in the number of incidentally detected indeterminate renal masses. Acquisition: axial, 3-mm reconstruction section thickness with or without 50% overlap. Note: This article is intended to outline some general principles of protocol design. Although the specifics of a renal protocol CT vary by institutions, the following phases in their various combinations commonly are used: precontrast phase, corticomedullary phase, nephrographic phase, and excretory phase ( Fig. IV contrast material type, volume, and injection rate: type, low-osmolar or iso-osmolar contrast material; volume, 35-g to 52.5-g iodine equivalent (ie, for contrast material that contains 350mg of iodine/mL, the corresponding dose is 100150mL); and weight-based dosing injection rate, 25mL/s. 0 Oregon Health & Science University is dedicated to improving the health and quality of life for all Oregonians through excellence, innovation and leadership in health care, education and research. Adrenal glands protocol (MRI) | Radiology Reference Article PelviS: renal STone ProToCol . 1. This phase is helpful for identifying RCC involvement of the collecting system as well as diagnosing primary malignancy arising from the collecting system, such as urothelial carcinoma involving the kidney ( Fig. Adrenal glands protocol is an MRI protocol comprising a group of MRI sequences put together to further assess indeterminate adrenal lesions, in particular, lipid-poor adenomas.. Therenal mass CT protocol is a multi-phasic contrast-enhanced examination for the assessment of renal masses. (, CT in a 57-year-old woman with a renal AML. SA`00, pCR hj~ ?g Current Procedural Terminology CPT 2022 MAGNETIC RESONANCE IMAGING - MRI COMPUTED TOMOGRAPHY - CT MAGNETIC RESONANCE ANGIOGRAHY - MRA MAGNETIC RESONANCE VENOGRAPHY - MRV . MRI EXAM CPT CODE REFERENCE Use this reference to quickly determine the correct exam for your patients based on the indications described herein and the . PDF Contrast Guidelines for Common CT/CTA MRI/MRA - ARA Diagnostic Imaging Phase oversampling and, in the case of 3D blocks, slice oversample, must be used to avoid wrap around artefacts. At the time the article was last revised Raymond Chieng had PDF MRI EXAM CPT CODE REFERENCE - Wake Radiology Computed tomography (CT) and MR imaging with intravenous (IV) contrast are the mainstays of renal mass evaluation. > Gadolinium should only be given to the patient if GFR is > 30 endobj Check for errors and try again. EXACT parameters as the COR mDixon precontrast. 0000013275 00000 n Trigger when contrast reaches SMA. Slices must be sufficient to cover both kidneys from two slices above the upper pole of kidneys down to two slices below the lower pole of kidney. In the setting of advanced RCCs, tumor extension into the renal vain or inferior vena cava may be best assessed on the nephrographic phase as well. 0000011400 00000 n Slices must be sufficient to cover both kidneys anterior to posterior. Ask the patient to remove all metal object including keys, coins, wallet, any cards with magnetic strips, jewellery, hearing aid and hairpins IV contrast generally is needed for the characterization, staging, surveillance, and post-treatment follow-up of renal tumors. ), T1 In-opposed phase breath hold axial 4mm. Renal masses increasingly are found incidentally, largely due to the frequent use of medical imaging. T2 tse breath hold 4mm axial. Renal Mass Characterization/Surgical Planning (if in conjunction with Pelvis CT w/contrast CPT Code 74178, IMG 783) Pancreatic mass characterization/surgical planning (if in conjunction . INTRODUCTION. Axial (, CT in a 75-year-old woman with a left renal lesion demonstrating higher lesion conspicuity in the nephrographic phase compared with the corticomedullary phase. Metallic foreign body in the eye CPT Code(s) to Precert MRI Breast Newly Diagnosed Breast Cancer . endobj e~20GPU#L Most adrenal masses are detected first on abdominal CT scans, with an incidence of 0.6 to 1.3 percent on such scans. 0000008503 00000 n Despite aggressive treatment in early stages of the disease, a clear positive effect in reducing kidney cancer-specific mortality is . 0000025763 00000 n More CPT Codes: CT | Solar Medicine | PET/CT | PET/MR | Ultrasound Breast/Chest/Cardiac MRI Musculoskeletal MRI Brain/Spine MRI Each testing takes about 45 minutes of scanning. For these masses, no further imaging is indicated. MR imaging serves as a problem-solving tool in renal mass evaluation, and MR imaging protocols should take advantage of its multiparametric capability to provide additional information for renal mass characterization. x]_sLHkG38NL&CsT[N4V" bISM-bw:=V7]nN~=\,O-o;|rqE&,Lr!O?$O|HD\|B_r~"gjf{x^'fv_'%|ONKE.5p%ujTd"gGVd PDF University Radiology To MRI & MRA Ordering Guide Papillary RCCs typically have low-level progressive enhancement that peaks in the nephrographic phase. q-5GXRR{uj[qma..v.Q Dj QcU)0M'(_5Acc:4A1g59{P ClWk38?l4 VL K;~ZDm*HI(cCccsFGZvcW |w`90nT`GaGX -mY Q#x\G)!oMZJ,BCd3s HYmVgU*# n(7g(m SeH+ZFZ l5nbsOY>p]9;? Notes: Indeterminate adrenal lesions are typically discovered incidentally on contrast enhanced Metal shrapnel or bullet, > CT CPT Codes - Mallinckrodt Institute of Radiology - Washington relative or staff ) >, A satisfactory written consent form must be taken from the patient before entering the scanner room Offer earplugs or headphones, possibly with music for extra comfort Our podiatrist states that she can report reading for MRI, if patient is bringing in the MRI disc with images and she read it [COLOR="#EE82EE"][/COLOR] Ok, so this seems silly, however, sometimes when reviewing information, there is not always a cut and dry answer to questions. endobj Nephrographic phase also may improve the assessment of enhancement in poorly vascular tumors. 9 ). 0000007179 00000 n Within the next several years providers will be required to observe appropriate use criteria AUC as a condition of payment when reporting certain services for Medicare beneficiaries. > Hematuria, > Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Protocol Optimization for Renal Mass Detection and Characterization, Added Value of Magnetic Resonance Imaging for the Evaluation of Mediastinal Lesions, Clinical Review of Computed Tomography and MR Perfusion Imaging in Neuro-Oncology, Radiologic Clinics of North America Volume 58 Issue 5, May be helpful to differentiate urothelial cancer from RCC and parapelvic or peripelvic cysts from hydronephrosis and to diagnose calyceal diverticula, Prepartial nephrectomy or preablation planning for renal masses that have been previously completely characterized, Better depict the arteries and their relationship to the renal mass. New HCPCS Level II modifier reports advanced diagnostic imaging provided to Medicare patients. More CPT Codes: MRI | Nuclear Medicine | PET/CT | PET/MR | Ultrasound, Prep: NPO 2 hours for all studies w/ contrastArrival time: 30 minutes prior to exam for registration and prep, Dissection (if in conjunction with Abdomen and Pelvis CT w/contrast please see Chest w/ and w/o contrast and Abdomen Pelvis w/contrast (CPT Code 74177, IMG 698). `|G]&s Such information can be helpful in guiding patient management. Last updated: 4/12/19. With increasing utilization of cross-sectional imaging such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), the detection rates of an incidental kidney lesion have increased over time [].While most incidental kidney lesions can be left alone as they will have no clinical consequences, some are pathologies (eg, renal cell carcinoma, renal . Contrast injection risk and benefits must be explained to the patient before the scan, T2 tse breath hold (TRUFI or HASTE)coronal, Use T1 VIBE fat sat axial and coronal after the administration of IV, CLICK THE SEQUENCES BELOW TO CHECK THE SCANS. xref 1 0 obj 80 0 obj <>stream Recent data also suggest that well-defined homogeneous renal mass with attenuation 30 HU or less on the portal venous phase CT can be considered benign cysts and require no additional imaging. Adding a U prior to the IV makes the exam ultralow dose, o BCT 02UIV abd pelv w/IV contrast, ultralow dose. no financial relationships to ineligible companies to disclose. PDF CT EXAM CPT CODE REFERENCE - Wake Radiology oD}tw.. The field of view, whether restricted to the kidneys themselves or expanded to include from the diaphragm to the iliac crest, also depends on the clinical questions. MRI CPT Codes - Mallinckrodt Institute of Radiology - Washington PDF MRI EXAM CPT CODE REFERENCE - Wake Radiology PDF MRI Ordering Guidelines Exam Reason for Exam Contrast? - Baystate Health > bYBqbQ-)(?x%r0810 Frequently, these clinical scenarios involve an older patient with comorbidities and a small renal mass (4 cm). Computed tomography (CT) and MR imaging are mainstays for renal mass characterization, presurgical planning of renal tumors, and surveillance after surgery or systemic therapy for advanced renal cell carcinomas. For patient comfort, if you. CT renal mass (protocol) | Radiology Reference Article - Radiopaedia endobj Patients with vomiting or dizziness with IV contrast or shellfish allergy do not require premedication. Protocol 1 Indications: Indeterminate renal mass Recommended scan series: Pre-contrast: kidneys only, axial, 3mm reconstruction section thickness with or without 50% overlap Nephrographic phase: kidneys only, axial, 3mm reconstruction section thickness with or without 50% overlap, at 100-120 second delay Optional additional scan series: Renal mass (cyst or solid) Transitional cell carcinoma of kidney Abnormal findings mri aBdomen: Adrenal MRI Abdomen with and without contrast 74183 Adrenal mass or lesion Hypertension Pheochromocytoma Determined by Radiologist Body mrcP: Biliary MRI Abdomen with and without contrast 74183 Abdominal pain Jaundice The group has suggested standardized CT protocols for renal mass evaluation based on different clinical indications, as described later. CT Protocol Cheat Sheet | UW Emergency Radiology - University of Washington % CT images are acquired in the axial plane, with suggested 3-mm reconstruction section thickness. Minimize SENSE if there is mottling in the center of the image. Protocols listed have been reviewed and approved by a radiologist. 0000001785 00000 n ydm7!d~!T. The patient had MRI w/o contrast for the HIP right side and MRI w/o contrast of the Knee right side. [QUOTE="bnmoody, post: 392628, member: 265484"] > For the assessment of benign renal lesions (e.g. Thirty patients undergoing four-phase renal CT scans for assessment of renal lesions (>10 mm) were included in the study. The specifics will vary depending on CT hardware and software, radiologists' and referrers' preference, institutional protocols, patient factors (e.g. Arterial phase (approximately 30-second delay) with field of view focused on the kidneys is recommended to better depict arteries and their relationship to the renal tumor. {"url":"/signup-modal-props.json?lang=us"}, Murphy A, Chieng R, O'Shea P, CT renal mass (protocol).
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