CECT Lower Limb Angiography | By Anis Qureshi

Описание: CECT Lower Limb Angiography | Complete Protocol — NCCT Phase, ROI Placement, Contrast Injection, Timing & 3D Filming | By Anis Qureshi

In this detailed tutorial, Anis Qureshi guides you step-by-step through the Contrast-Enhanced CT Angiography (CECT) of Lower Limbs, explaining everything from NCCT phase to final 3D reconstructions.

📌 Step-by-Step Procedure:

1️⃣ Patient Preparation:

Fasting for 4–6 hours.

Check serum creatinine before contrast.

Remove all metallic objects from lower limbs & pelvic area.

Explain warm sensation during injection to patient.


2️⃣ Positioning:

Feet-first supine on CT table.

Legs straight, slightly apart, toes pointing up.

Arms above head (if possible) to reduce artifacts.

Center pelvis and limbs in gantry midline.


3️⃣ NCCT Phase (Pre-contrast):

Do an NCCT pelvis to feet scan first to check for calcifications, prosthetics, and baseline anatomy.

This also helps in differentiating calcified plaques from contrast-filled vessels in later phases.


4️⃣ ROI (Region of Interest) & HU Trigger:

Place ROI on abdominal aorta just above the bifurcation (L4 level).

Set trigger at 120 HU for arterial phase.

Ensure ROI is only on the lumen, avoiding vessel wall calcifications.


5️⃣ Contrast Injection Protocol:

Contrast: Non-ionic iodinated contrast (e.g., Iohexol 350 mgI/ml).

Volume: 1–1.5 ml/kg body weight (average adult: 80–100 ml).

Injection rate: 4–5 ml/sec via 18–20G cannula in antecubital vein.

Follow with 30–40 ml saline flush at same speed (dual-head injector).


6️⃣ Timing & Phases:

Arterial Phase: Triggered automatically when ROI HU threshold reached (150–180 HU).

Venous Phase (optional): Delay of 15-20 seconds after contrast injection start for venous mapping or DVT assessment.


7️⃣ Scan Parameters:

kVp: 100–120

mAs: Automatic dose modulation

Slice thickness: 0.5–1 mm (thin slices for angiography)



🎥 Filming & Reconstructions:

Axial MPR: For detailed lumen assessment.

Coronal MPR: Full arterial pathway in one view.

Sagittal MPR: Side view for segmental stenosis.

MIP (Maximum Intensity Projection): Enhances vessel visualization.

3D Volume Rendering (VR): Surgical planning & patient education.

Bone Removal Technique: Clear visualization of vessels without bony overlap.


🔍 Diagnoses Possible with CECT Lower Limb Angiography:

Peripheral arterial disease (PAD)

Arterial stenosis or occlusion

Aneurysms

Vascular malformations

Pre-surgical vascular mapping

Post-graft or stent evaluation

Traumatic vascular injury

Venous thrombosis (with venous phase)


🎯 Who Should Watch:
Perfect for Radiology students, X-ray/CT Technicians, Vascular Imaging trainees, SSB aspirants, and practicing Radiographers.

📌 Follow for more radiology tutorials:
Instagram: @anisqureshi0


🔖 Hashtags:
#CECT #CTAngiography #LowerLimbAngiography #CTA #CTScan #Radiology #Radiographer #CTPositioning #ROI #ContrastInjection #HUTrigger #CT3D #AngioCT #RadiologyTutorial #VascularImaging #AnisQureshi #JKSSB #PeripheralArteryDisease #CTBoneRemoval #CTMIP #CTVascular #CTVR #CTProcedure


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