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CT Cystogram

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Non-Contrast Non-Contrast Diaphragm to Pubic symphysis
    Cystogram Contrast (100 sec delay) Diaphragm to Pubic symphysis
    • Bladder rupture
    • Bladder injury
    • Post-operative bladder assessment

  • 2. Patient Prep

    • Position: Supine
    • NPO Status: NPO 2-4 hours
    • Pre-Medication:
      • Bladder contrast: 350-400 mL dilute contrast (30 mL contrast in 350 mL saline)

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 100 mL
    Flow Rate 3-4 mL/s

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • TWO components: 1) Non-contrast CT 2) Bladder filling via Foley with dilute contrast 3) Scan distended bladder. Coordinate with nursing
    • Additional Recons: Compare distended vs non-contrast. Document extravasation location. 3D reformation if complex injury
    • Foley catheter required. Dilute contrast preparation (30mL in 350mL saline). Gravity fill bladder. Patient signals fullness

    Safety First

    • Renal Function: eGFR doesn't matter, contrast not excreted
    • Allergy: Foley placement. Prepare dilute contrast
    • Cystogram: bladder integrity extravasation
    • Adequate bladder distension critical. Gravity fill slowly. Clamp Foley during scan
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Diaphragm Pubic symphysis N/A N/A AP
Non-Contrast Diaphragm Pubic symphysis 70 sec 2.5 mm Standard IV contrast
Bladder Filling N/A N/A 90 sec N/A Fill via Foley - not scanned
Cystogram Iliac crests Below bladder 100 sec 2 mm Scan distended bladder
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Non-Contrast Pelvis 2 mm/2 mm Standard 3 Pre-contrast
Axial Cystogram Pelvis 2 mm/2 mm Standard 3 Distended bladder assessment
Coronal Cystogram Pelvis 2.5 mm/2.5 mm Standard 3 Bladder overview
Sagittal Cystogram Pelvis 2.5 mm/2.5 mm Standard 3 Bladder dome and base