Artifacts in Multi Slice CT

Artifacts can critically degrade the quality of calculated tomographic (CT) images, sometimes to begin making them diagnostically unusable. To be able to optimize image top quality, it is necessary to understand the reason why artifacts occur and exactly how they can be prevented as well as suppressed. CT artifacts originated from a range of sources. Physics-based items result from the actual processes involved in the acquiring CT data. Patient-based artifacts originate from such factors while patient movement or even the presence of material materials in or even on the patient. Scanner-based items result from imperfections inside scanner function. Helical along with multisection technique artifacts are designed by the image renovation process. Design functions incorporated into modern CT scanning devices minimize some types of items, and some can be in part corrected by the reader software. However, in most cases, careful patient placement and optimum choice of scanning parameters would be the most important factors while we are avoiding CT artifacts.
Thin-slice images refurbished from helical multi-slice CT scans normally display artifacts referred to as windmill artifacts, that arise from not really satisfying the Nyquist trying criteria in the affected person longitudinal direction. Since these tend to be essentially aliasing artifacts, they could be reduced or eliminated by trading away from resolution, either throughout the world (by reconstructing fuller slices) or in the area (by local removing of the strong gradients). Well-known drawback to this approach will be the associated loss in decision. Another approach would be to utilize an x-ray conduit with the capability to modulate the actual focal spot inside z-direction, to effectively help the sampling rate. The work presents a new means for windmill artifact lowering based on total alternative minimization in the image area, which is capable of taking away windmill artifacts yet still time preserving the particular resolution of anatomic houses within the images. This can be a big improvement more than previous reconstruction strategies that sacrifice solution, and it provides pretty much the same benefits as being a z-switching x-ray tube with a more simple impact to the all round CT system.

Julia F. Barrett, MSc and Nicholas Keat, MSc
1From Imaging Performance Assessment of CT Scanners (ImPACT), St George’s Hospital, Blackshaw Rd, London SW17 0QT, England. Presented as an education exhibit at the 2003 RSNA scientific assembly. Received April 5, 2004; revision requested May 7; final revision received August 20; accepted September 1. Both authors have no financial relationships to disclose.

Brain Tumor CT-Scan Examination Techniques

CT examination was carried out acts specifically on the head. Not only performed on patients suffering from head trauma, but it turns out this examination can detect various abnormalities in the patient's head is:     Tumors, masses and lesions. In the brain tumors,the sulci may also be obligated by expanding lesions within the brain suck as a tumor or an absecess. In addition to mechanical compression of the sulci, associated swelling of the surrounding gyri from oedema leads to appearance of complete obliteration of the sulci as shown in the figure. To summaries , we have learn that the brain surface consist of gyri and that sulci normally filled with brain cerebrospinal fluid (CSF),which get replaced by blood or is squeezed out by swelling of the brain from oedema or expanding mass

Before the examination by means of CT, the officer must give the position instructions and inspection procedures to patients. Especially if the examination using contrast media. Also explained that the object of accessories such as false teeth, false hair, earrings, hair accessories, and hearing aids must be removed first. Because it will cause artefak. The patient should the patient be given a blanket because the room was very cold.Preparation tools and materials used for the examination of the head is divided into two, namely:1. Sterile equipment:

• Injection tools
• Syringe.
• Gauze and cotton
• Alcohol 

Non-sterile equipment

• Plane CT-Scan
• Contrast media
• Oxygen tube

CT-scan of the head of pediatricshould using nonionic contrast media  . This function is to suppress reactions to contrast media such as dizziness, nausea and vomiting. Anesthetic drugs may be used if needed. Contrast media used for anatomical structures can be distinguished clearly distinguishable. (Such as blood vessels and other body organs). Contrast media can reveal the presence of abnormalities in the body like a tumor. (Seeram, 2001) This type of contrast media, among others omnipaque, Visipaque with volume usage: 2-3 mm / kg, maximum 150 m. While the injection rate: 1-3 mm / secExamination TechniquesPosition the patient in CT Scanning is the patient supine on the examination table with your head close to the gantry. While the Object Position is the head hiperfleksi and take the head holder. Head is positioned so that the mid sagittal plane of the body parallel to the longitudinal indicator lights. While Interpupilary line parallel to the horizontal indicator lights. The patient's arm is placed on the abdomen or in addition to the body. To reduce the movement of the forehead and the patient should fixation use a special belt holder on the head. The knees were given a booster for the convenience of the patient (Nesseth, 2000).

 Setting of Scan Parameters

• Use the type of scanogram on  lateral head. Then take the range I of the basis cranii to pars petrosum and range II of pars petrosum to the vertex. The slice Thickness is 2-5 mm (range I) and 5-10 mm (range II) with FOV: 24 cm. The gantry tilt angle depends on the size of the angle formed by the orbito meatal line with vertical lines.
• Sett your power machine use kV: 120 an mA: 250 and the algorithm reconstruction are on soft tissue mode.
• Window width: 0-90 HU (supratentorial brain); 110-160 HU (posterior fossa brain); 2000-3000 HU (bone)
•  Window Level: 40-45 HU (supratentorial brain); 30-40 HU (posterior fossa brain); 200-400 HU (bone)

Contrast media can reveal the presence of abnormalities in the body like a tumor. Taking photos must before and after intake of contrast medium. In general, a CT-scan of the head takes 6-10 axial slices. But such measures can vary depending on the purpose of diagnosis. For cases such as tumor, the number will reach two time slices because they have made images before and after introduction of contrast media. Purposes made income before and after shots of contrast media is to be able to distinguish clearly whether the organ is abnormal or not.

• Axial pieces I was most superior part of the brain called the hemisphere.
• Axial IV pieces to the four axial slices is called the medial ventricle.
• Axiak  V Describe the brain tissue in the medial third ventricle.
• Axial pieces VII is a seven slices to a depiction of the field of orbital tissues. Structures in this slice is difficult to be revealed by both the CT-scan. 

The right-sided small lesion and oedema are squeezing neighboring sulci and gyri similar to schematic illustration. Note the density of the oedema surrounding the lesion. The white matter normally appears less dense than the cortex as seen on the left hemisphere in this scan. It is referred to as grey white differentiation on the ct scn. But the odedema from the lesion is darker than the normal white matter low density and it is not brain cerebrospinal fluid (CSF).

Drawing of the effect of an extra axial mass on brain and a CT scan showing an ISODENSE mass. Can you detect asymmetry in two halves of the scan?Can you make out where the tomour is?

MSCT Uro ,The Examination Procedures in The Urinary Tract

This procedure have purpose  to determine the position of abnormality / presence of kidney stones until ureter. Governance of the Uro MSCT with cases of urinary tract stones are not using oral contrastThere are two kinds of procedures for implementing MSCT Uro. It is used to implement the following procedures:

I. Procedure without the use of contrast 

Preparation of patients with the procedure without the use of contrast is not that complicated. officers do not need to drink oral contrast. Patients also do not hire to fasting. Once the patient is ready immediately the implementation of the photo. The patient supine on the examination table feet first with the position of the gantry on the abdominal area is set amid the FOV (Field of view). Please load the scout plane / scanogram with a central point (CP) on processus xypoideus. Then Create a non-contrast axial cut from the diaphragm to the pool below the kidneys, which are used thicknes and the interval of 5 mm. Reconstruction interval 1.25 mm thickness 

 II. By contrast injection 

Preparation of patients with this procedure is without a drink oral contrast administration. The contrast fluid is injected in the patient's body. Patients fasted 4 hours . Then the patients must perform a check of renal function creatinine urea.In the implementation of the photos, patient supine with feet first over the kitchen inspection gantry position on the abdominal area is set amid the FOV (Field of View). Scout immediately made plane / scanogram with a central point (CP) on processus xypoideus. Immediate non-contrast axial cuts made from the diaphragm to the pool below the kidneys, thickness and used 10 mm intervals. After that create a piece of post-contrast axial 5 mm in thickness and reconstruction interval of 1, 25If there is anything that can be used an additional way of contrast let prep group. that is, if there is kidney dam then do prep group 5 minutes. when needed can be made late delayed 30 minutes. But if there is no kidney dam: prep group only 60 seconds. While the contrast required flow rate 50 cc 3 cc / sec. Please to do a scan immediately return such as phase contrast with a standard non-prep group that has been determined. Next step is to reformat the image. Coronal reconstruction of axial reformat made, in the abdomen from the diaphragm to the pubic simphisis with 5 mm thickness and interval. Of reconstruction created axial coronal reformat in the abdomen from anterior to posterior abdominal abdomen with 5mm thickness and interval. While the reconstruction created axial sagittal reformat the abdominal region of the abdomen from right to left abdomen with 5 mm thickness and interval. The image was then printed in the film are:
 Film type are follow as : 

1 sheet for the axial position (format 24),1 sheet to position the coronal and sagittal (format 24),1 sheet for a special picture that appears displays the abnormality 2 (rock) should be measured in diameter (format 6 or 8). 

Protocol for Pleural Cavity/ Mediastum

In the case of trauma accepting the patients position as much as possible. This may be adequate alone but contrast enhancement will greatly increase the amount of information obtained

An enhanced scan should be performed if vascular or nodal involvement is in questions and both pre and post contrast scans should be performed routinely for comparison in initial staging scans. From then on , either on alone may be indicated depending on the departmental protocol

It si usually only necessary to have set of reconstruction on lungs algorithms and lung settings, either pre or post contrast enhancement

In the case of trauma where time is important , a single enhanced scan will give maximum information

Enhanced scan parameters are similar to those of the routine unenhanced scan, following the administration of 50-100 ml of intravenous, preferably non–ionic administered through the antecubital vein at a rate of 2 ml/s , either by hand or pump injection

The scan should be initiated after 30 sec, allowing optimal visualization of medicinal vessels. Scans performed in this way can seen in figure and comparison can be mate with the unenhanced images.

Figure 1. IV Contrast –enahanced thorax scan at level of the aortic arch.

Figure 2.IV contraxt-enhanced scan demonstrating cardiovascular vessels. Comparison can be made with unenhanced images

Fgure 3. IV contrast enhanced thorax scan demonstrating left and right ventricles and septum. Comparison can be made with figure 2

Use Conventional CT

In practice helical scanning for thorax has now become routine for CT imaging and in the main is used for diagnostic purposes,. There are a few instances where conventional CT may still be preferred and these are listed below :

• High resolution (HR) CT for detailed imaging of lung parenchyma . differentiation of pulmonary nodules and focal lung diseases. Incremental acquisition using narrow beam collimation , in the writers experience, is still protocol of choice. Nevertheless ,s studies are beginning to show that helical acquisition may provide similar information since a volume acquisition may provide similar information , since volume acquisition allow data be reconstructed retrospectively (Figure), to overlap slices directly through the centre of pulmonary nodules of areas of interest. This provides more information without further scanning of the patient and reduces partial volume artefact : however the detail may not be equal to that of incremental scanning
• Biopsy, aspiration, drainage, although helical acquisitions is useful for identification of lesion or collection, it has little advantage over conventional scanning for accurate localization. It has preciously been suggested that interpolation algorithms employed for image reconstruction, may produce a less than accurate representation . In practice, however , it seem to make little difference.
• Radiotherapy planning. Helical CT is not widely used as yet because patient translation along z –axis and image interpolation may affect treatment planning. 3d reformatting tough, can be used to aid planning

If helical acquisition is not an opinion then conventional slice by slice scanning using contiguous slices clustered together, if possible, to reduce the number of breath-hold, will provide information similar to that of helical scanning

Helical Versus Conventional CT

The advent of helical CT Scanning has greatly increased the potential of CT imaging of the thorax. Short acquisition times, utilizing a combination of slip ring technology, patient translation, movement reduction algorithms, higher powered X ray tubes with rapid heat dissipation and more efficient X ray detector, allow the entire thorax to be imaged in matter of seconds. Most importantly this usually means within a single breath hold.

Ct imaging of the thorax may necessity demonstration of the bony thoracic cage and the soft tissue structure within , in their entirety, or it may focus on a particular organ or pathology. One or all of the following areas may included:

• Pleural cavity
• Mediastinum
• Cardiovascular structures
• Bony cage ribs and sternum

All of these structures move on respiration , there fore single breath-hold scanning techniques have revolutional CT Thorax scanning. This and other advantages of helical scanning of the thorax are listed below:

• The data is continuous, because a whole volume is scanned
• Small areas pathology are unlikely to be missed; this can happen with conventional CT Scanning if the slices are not contiguous
• The whole volume can scanned in one brath-hold, so there is no misregistration of data due to respiratory movement
• Contrast enhancement is more uniform through the study so the amount used may be reduced, optimised and captured to perform CT angiography or multiphase studies
• It can be faster for the patient; this has excellent indications for pediatric , geriatric and trauma scanning and for increasing workloads
• Imaging manipulation, such as multiplanar (MP) and three dimensional (3D) reformatting of images, shaded surface display (SSDs) and maximum intensity projection (MIPs), has expanded and improved because the continuous data acquisition allows overlapping slices abnd reconstruction at any point within the volume of raw data. This has helped to make CT angiography a reality
• Advanced 3D post processing techniques are now being developed to allow a simulated view from inside a lumen or anatomical space, indicating that indicated intraluminal angiography
•  And simulated bronchoscopy may be examination of the future
• A radiation dose reduction is indicated because the likelihood of repeat scans due to patient movement is reduced. Also the scans are undertaken at a lower mAs values because of the height tube output required for spiral CT scanning: this is a direct reduction of radiation dose.

It can seen that the benefits to the patient and imaging department of the fast volume data acquisition are manifold. There are of course some disadvantage which are generally outweighed by the advantages and which are reducing with rapidly improving CT technology . They do however , warrant a mention

Patient Preparation of Abdomen CT Scan

The main drawbacks of single-slice spiral CT are either insufficient volume coverage within one breath hold time of patient or missing spatial resolution on z axis due to to wide collimation. With single slice spiral CT the ideal of isotropic resolution ,i.e. of equal resolution in all three spatial axes, can only be achieved for very limited scan ranges,

Examination preparation to the patients for CT scanning examination on their abdomen , they must to do fasting about 8 hours before the examination of CT Scanning, but they can to drink the mineral water just do not drink soda or alcohol. One hour before the examination patients were asked to defecate (can be done at home or inpatient room). For helping  good image and clear the patient can give laxative drug.

Preparation of drugs

These drugs are non-ionic Liquid Contrast Media 100cc, 20 cc Spuit 4 pieces, 4 pieces of needle size 19G, 21G wing needle size 1 fruit, 1 small 50 cc syringe, Foley catheter size 16, and bottled mineral water 1 piece . ,
For the case of children please consult a doctor of radiology, because of different clinical and weight affect the entry of contrast, for certain cases the amount of contrast medium can be added, we usually add 30 cc of contrast liquid is greater if the patient's posture or there is clinical-clinical specialty. contrast allergic reaction should be minimal and not costly.
All drugs were included as phase contrast. Contrast liquid is divided into three parts, namely intravenous, oral and anal. For the intravenous dose divided into three 75 cc 20 cc syringe filled to the brim. 20 cc syringe has an tolerance of 5 cc so if aspirated will be filled full of 25 cc.
For oral contrast, dilute 10 cc of contrast into 300 cc of liquid to drink mineral water. .When giving to the patient because the patient will put the drinking straw while sleeping.Contrast liquid for anal use aqua bidest sterile, 15cc of contrast liquid is diluted to 300cc. Use a sterile tray to dilute them, to prevent nosocomial in the colon. Thank you

The 5 Most Popular Types of CT Scan Examination

Computerized Tomography Scanner or CT Scanner out uses X-rays to obtain three-dimensional images associated with body parts and organs. CT scanner operate with a different acquit ion mode called retrospective gating. The combination of fast gantry rotations , slow table movement and multi slice helical acquisition allows for collection of a high amount of X ray projection data. The XS-ray projection of mid are selected to reconstructed images from the patient body.

CT scan can be used to scan one body organ (eg heart) or check out the entire body in general. CT tests are often paired with other checking method called positron emission tomography, or even PET scan to get the outcomes that much faster.

Here are the most popular types of CT scanner performed:

1. The Abdomen CT Scan

Abdominal CT check out is used to diagnose patients along with problems in the organs within the abdominal cavity. CT scans supply visual data more detailed compared to conventional X-ray scanning. Abdominal CT check out can diagnose problems in a variety of organs including kidney, liver organ, spleen, pancreas, small intestine as well as colon, bladder, and gall bladder.

2. Whole Body CT Scan

Entire body CT scan produces three-dimensional images of all of the bones and organs through the body.CT scan is usually carried out starting from the bottom of the face to just below the hip, even though if necessary can be done from visit foot.Whole body CT scan is usually performed as a preventative calculate to look for signs of disease or even abnormality.

3. Brain Check out CT Scan

CT scan brain was done particularly to scan the brain body organ. These scans are used to identify brain injury, brain stress, tumor or cancer, as well as aneurysms.In addition, CT scan of the mind can also be used to find cavities within the brain in people struggling with hydrocephalus. CT brain scans are very useful when you are preparing for radiation therapy and helps physicians discover a brain tumor needing biopsy.

4. Chest CT Scan

Upper body CT scan gives doctors the three-dimensional chest cavity with a more in depth picture than that supplied by traditional X-ray scanning. Chest CT check out shows detailed images from the lungs, ribs, heart, arteries and arteries and upper body. CT scans can show a number of issues, including clogged arteries, heart disease and cancer.

5. Specific  Body organ CT Scan

In addition to several types of the above, the CT scan may also be done on a particular body organ as needed.
CT scans of the coronary heart for example, provide visual info to help diagnose heart disease as well as clogged arteries. Kidney as well as liver CT scan can help identify problems in the kidneys as well as liver. []

Preparation of Thoracic CT Scanning

This may begin as early as when the patient makes appointment or is on the ard as an impatients:for the patient to have prior information about the in-patient procedure that has been requested is good background preparation. Information leaflets at reception, in the waiting room or sent to the ward are useful. Any allergy or asthma history should be obtained as early as possible if steroid cover is to administration, dependent upon department policy.

This scanning procedure should be explained clearly and  concisely to the patient as well as the necessity and purpose or oral and IV contrast. The patient should be given an idea as to the duration of the examination and told how they can be communicate with the radiographer. Reassurance that they can be heard and spoken to often helps patient, as well as a frequent update as to how well the procedure progressing, In the writer experience, an explanation as to why it may appear to the patient that, on occasion, nothing is happening, is useful; this is when patient may become anxious and is often due to radiographer concentration on images rather than on the patient! This may be the 10^th scan of the day, but to patient it is the one and only and can make a lasting impression; a relaxed patient is still one making the procedure easier for everyone.

Breath-holding techniques are very important for thorax scanning and should, therefore, be explained to and practiced with the patient

All patient details , as far as possible, should be enters prior to positioning the patient since this also reduces the time the patient is lying in scanner.

Reducing Artifact use 3D Recontruction

Reducing artefact on CT system is can do with more technique. The main improvement on the multiplanar reconstruction and 3D has been around since the introduction of helical CT scans and increased again with multislice CT.
 
Helical artifacts in multislice scanning 
On Ct Scan more readily multislice image distortions resulting from interpolate ​​helical transactional than single slice CT Scan. But with the use of z-helical interpolation filter for the interpolation of two points, especially when the filter width used is wider than the detector acquisition.The relationship between helical pitch and the damage caused by more complex artifacts in multislice CT scans than single slice CT Scan. Reduced artifacts appear when the value of non-integer pitch, relative to the width of the detector acquisition is used. This is because the z-axis sampling density maximum for non-integer pitch. 

The Cone Beam Effect 
The cone beam effect a potential cause of artifacts in multislice CT. When the tube and detector around the object, the same data collected by each - each loaded detector volume between the two cones, rather than an ideal straight field. Artifacts more visible on the outside of the detector rows than the inside, when the data collected closer to the field.Manufacturer's efforts to reduce cone beam artefacts. Cone beam artefacts look worse in thin slices and wide cone angle. Making the 16 slice CT Scan should be more artefact than the potential occurs 4 slice CT Scan. However, manufacturers have solved the problem by applying a variation form cone beam reconstruction than a standard reconstruction techniques used in CT 

Stair step artefacts 
Stair step artefacts visible around the edges of structures on multiplane and 3D reconstructions when Collimation of wide and non-overlapping reconstruction interval used. Stair step artifacts virtually disappear on multiplanar and 3D reconstruction with a thin slice multislice CT Scan date.

 Zebra Artefacts 
Strip may look dim on multiplane and 3D reconstruction in helical, helical interpolation process due to an increase in the degree of noise is not homogeneous along the z-axis. Effect of 'zebra' become more apparent from the rotation axis is not homogeneous due to noise is worse in the off-axis.

scan 4 slices.

Axial CT Slices of the Abdomen to Detect Amebic Abscess Liver

Hepatic infections may caused by bacterial (85%), fungal(9%) or parasitic (6%) infections. The most common causative agent are E .colli, Streptococci, Actinomyces,Candida, Entamoeba histolytica and Echinococcus.

CT is today probably the most reproducible way for imaging liver. With advent of newer CT technology strategies of evaluating the liver have been devised.

Spiral CT(SCT) made acquirement of anatomically consecutive axial sections through liver in single breath–hold and to repeat this procedure in several phases after intranet-vascular in section of contrast medium possible.

Location for the lower abdominal region taken from a CT-general begins with the first slice in the xiphoid process illiaca forwarded to the crista. For the pelvic area taken in the first slice starts with crista illiaca and forwarded to the symphysis pubis. For routine abdominal examination is generally 10 mm thick slice. 
On a routine abdominal examination with serial scanning takes ± 1 second to see the process of peristalsis and respiration. (Bontrager, 2001).
Contrast media preparation

Availability of contrast media injectors also contributed to the standardization of this injection to more accurately depict the different vascular phases during distribution of contrast medium enabling both detection and characterization of focal liver lesions.

Contrast media through the mouth and rectum for a CT-Abdomen and pelvis (rectal contrast media used if oral contrast media can not get into the rectum). Oral contrast media through to see or distinguish the organ in the gastrointestinal tract. There are 2 (two) types of contrast to show the opacity of the tractus gastrointestinal barium sulfate suspensions and water-soluble solution (diatrizoate meglumine or diatrizoate sodium) (Bontrager, 2001).
Oral contrast medium administered before the examination. There are 3 (three) levels of media contrast administered orally to patients:

• The night before the examination.
• One hour before the examination.
• In the middle before the examination.

Routine abdominal CT protocols consist of a axial plain survey of liver. Spiral CT scan the abdomen pelvis after oral and intravenous administration of contrast material. Typically, 100 mL(300 mg/mL iodine) of iohexol is injected at arate of 2-3 mL/sec. Beginning 25 second after initiation of the contrast material injection, a30 second breath-hold arterial phase helical CT scan was acquired with section thickness of 5 mm and pich (usually 1.0-1.6) sufficient to cover the entire liver within the breath-hold period.

A breath-hold portal venous phase scan was obtained 60-70 second after initiation of the   injection. Images were reconstructed at 3 mm intervals through the lesions with use of standard soft tissue(windows with, 400 HU;level,40 HU) and liver (windows width, 150 HU;level ,50-80 HU)display settings.

Axial slices of the Abdomen

The axial CT slices of the abdomen with 10 mm of each slice. First with 50 cc bolus injection and drip infusion of 100 cc with intravenous contrast. Preparation of oral contrast with water-soluble solution.
Film processing is to convert the latent image in the form of emulation of the film during exposed  transformed into a shadow form of silver through a chemical process. (Jenkin, D, 1980)
Automatic film processing is the process of processing the film with the film transport system, followed by a working roller with face velocity. In automatic film processing using the solution concentration and high temperature of the manual process so much faster time.

Entamoeba histolytica is endemic worldwide, with as estimated 10% of the worlds population being infected. It is most prevalent in India , Africa, the Far East and central and south America. Amebic liver disease is the most common extras intestinal complication occurs because colonic trophozoites ascend via the portal vein and invade the parenchyma.

See the figure Axial CECT showing a capsulated segment 3 abscess.

Contrast enhanced CT, amebic abscess usually appear as rounded , well defined lesions with attenuation values that indicate the presence of complex fluid(10-20HU). An enhancing wall 3-15 mm in thickness and peripheral zone of edema around the abscess are common and some what characteristic for this lesion. The central abscess cavity may show multiple septa or fluid-debris levels and , rarely , air bubbles or hemorrhage. Extrahepatic extension of amebic abscess is relatively common and involvement the chest wall, pleural cavity, pericardium an adjacent viscera has been reported.

Vertebral CT Scan Examination Techniques

The vertebral column is composed 33 irregular bones that extend from the base of the skull through the entire length of the neck and trunk. With the attachment of muscle , ligament and supporting inter vertebral disc, the column forms a strong, flexible support for the body while protecting the spinal cord and its surrounding meninges.

The column can be divided into upper 24 presacral vertebrae, which remain separate throughout life and the fixed vertebrae, which constitute the five sacral and four coccygeal segments. Although a detailed explanation of the anatomy is beyond the scope of this text, an understanding of the basic anatomic features  of the vertebral column is necessary to appreciate the abnormalities that maty be encountered in spine-injured patient.

There is no special preparation on the patient, only instructions-instructions regarding patient positioning and inspection procedures shall be notified so clear. Examination will performed in the cold room, so the patient should be closed down blanket. Patient must replaced with a dress shirt patients in order to avoid artifacts arising.
Tools and Materials Preparation
Tools and materials for a CT scan of the lumbar vertebrae Columna:

•      Plane CT-Scan
•      Apron
•      Oxygen tube
•      Blanket
•      Sstandard infusion

Examination techniques

• Patient positioning: Patient supine on an exam table with an upper limit on the processus xypoideus object, the patients were immobilized band so that the patient does not move.
• The position of the object: Mid sagittal plane (MSP) is placed right in the middle of the patient examination table. Both hands placed over his head holding on to the handle. The upper limit is set on the processus xypoidus object. Mid Coronal Plane (MCP) is set on the center line of the horizontal plane. Lower limit is set at the symphysis pubis object. Patients were fixed to avoid movement of the patient during the examination takes place.    
• The Scan parameters are follow as :

         Scanogram: Side View
         Slice Thickness: 5-10mm
         Range: up to simpisis xypoideus processus pubis
         FOV: 39 cm
         kV: 120
         mas: 205
         Reconstruction algorithm: High resolution
         Window width: 300
         Window level: -50 to -100
Film Processing
This is example of vertebra axial Ct Scan Imaging :