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CTA Upper Extremity

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    CTA Arterial Arterial (bolus tracked) Aortic arch to Fingertips
    • Upper extremity arterial insufficiency
    • Trauma
    • Dialysis access planning
    • Thoracic outlet syndrome

  • 2. Patient Prep

    • Position: Supine with affected arm raised above head or at side depending on indication
    • NPO Status: NPO 2 hours

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 100 mL
    Flow Rate 4 mL/s
    Timing Method Bolus Tracking
    ROI Placement Subclavian artery
    Trigger (HU) 150 HU

    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

    • Scan from aortic arch to fingertips. May need bilateral for comparison. Position arm to demonstrate pathology
    • Inject into contralateral arm
    • Additional Recons: MIP and 3D VR. Subtract bones for vessel visualization
    • 20G IV in contralateral arm

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history. IV in opposite arm
    • Assess subclavian axillary brachial radial ulnar arteries. Look for stenosis occlusion or injury
    • Position arm to avoid overlap with torso. May need special positioning for TOS
Series Name Start Location End Location Delay Slice Thickness Notes
Scout/Topogram Aortic arch Fingertips N/A N/A AP of arm
CTA Arterial Aortic arch Fingertips Bolus tracked 0.625 mm Include arch through hand
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Arterial Full arm 1.5 mm/1.5 mm Vascular 3 Primary diagnostic
Coronal Arterial Full arm 2 mm/2 mm Vascular 3 MIP full vessel course
Sagittal Arterial Full arm 2 mm/2 mm Vascular 3 Lateral MIP
3D VR Arterial Full arm 1 mm source Vascular 3 3D reconstruction