RadteraCT Head With Contrast
CT+ ContrastNeuro
Indications
- Suspected intracranial mass or metastasis (when MRI unavailable/contraindicated)
- Suspected infection/abscess, empyema, meningitis complications
- Follow-up of known tumor, postoperative tumor bed
- Suspected dural venous sinus thrombosis (often CT venography)
- Vascular lesion evaluation when MRI not feasible
Patient prep
- Screen renal function/eGFR per institutional contrast policy; document contrast allergy and premedicate if indicated
- IV access (typically 20-22 G)
- No routine NPO, though many sites hold solids ~2-4 h for contrast
- Remove metallic objects from field; position supine head-first in head holder
Contrast
Agentiodinated (e.g. iohexol 350 or iopamidol 370)
RouteIV
Dose≈70-100 mL at 1.5-3 mL/s
TimingPost-contrast acquisition at ~60-90 s delay (parenchymal/equilibrium); for CTV ~45-60 s
Technique
- Supine, head first; coverage foramen magnum to vertex
- Often paired with a non-contrast series for comparison depending on indication
- 120 kV; mAs per scanner with AEC; iterative reconstruction
- Reconstruct soft-tissue 4-5 mm axial plus thin source for coronal/sagittal reformats; bone kernel if osseous involvement
- No breath-hold required
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial post-contrast (soft tissue) | axial | 4-5 mm | Brain window; evaluate enhancement |
| 2 | Coronal reformat | coronal | 2-3 mm | From thin source |
| 3 | Sagittal reformat | sagittal | 2-3 mm | |
| 4 | Axial bone (optional) | axial | 0.625-1.25 mm | If skull base/calvarial involvement suspected |
Key points
- MRI with contrast is generally preferred for tumor/infection; CT with contrast is a substitute when MRI is unavailable or contraindicated
- Pre- and post-contrast comparison helps distinguish enhancement from hemorrhage/calcification
- For suspected dural sinus thrombosis perform CT venography with venous-phase timing
- Iodine load modest for head; balance opacification vs dose
References
• ACR–ASNR–SPR Practice Parameter for the Performance of CT of the Brain
• ACR Appropriateness Criteria: Headache; Neurologic Deficit
• Radiopaedia: CT brain with contrast link
• ACR Manual on Contrast Media
• ACR Appropriateness Criteria: Headache; Neurologic Deficit
• Radiopaedia: CT brain with contrast link
• ACR Manual on Contrast Media
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.