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DICOM PS3.17 2020a - Explanatory Information​

Page 791​

AAAA.2.1 Common Context​

Table AAAA.2-1 is basically the same for each model so it is shown here rather than duplicating it. The second half for two different​ scanner models is then shown below in Table AAAA.2-2 and Table AAAA.2-3.​

 

Table AAAA.2-1. Routine Adult Head - Context​

Attribute​

Tag​

Value​

Equipment Modality​ (0008,0221)​CT​

 

Custodial​

(0040,A07C)​

 

Organization​

 

 

Sequence​

 

 

>Institution Name​

(0008,0800)​Mercy Hospital​

 

>Institution Code​

(0008,0082)​

 

Sequence​

 

 

Responsible Group​

(0008,0220)​(C2183225, UMLS, "Neuroradiology")​

 

Code Sequence​

 

 

Protocol Name​

(0018,1030)​AAPM Routine Adult Head (Brain)​

 

Potential Scheduled​ (0018,9906)​(24725-4, LN, "CT HEAD") ,​

 

Protocol Code​

(24726-2, LN, "CT HEAD WITHOUT THEN WITH IV CONTRAST") ,​

Sequence​

(24727-0, LN, "CT HEAD WITH IV CONTRAST")​

…​

PotentialReasonsfor​(0018,9908)​Acute head trauma\​

Procedure​

Suspected acute intracranial hemorrhage\​

Immediate postoperative evaluation following brain surgery\​

Suspected shunt malfunctions, or shunt revisions\​

Mental status change\​

Increased intracranial pressure\​

Headache\​

Acute neurologic deficits\​

Suspected hydrocephalus\​

Evaluating psychiatric disorders\​

Brain herniation\​

Drug toxicity\​

Suspected mass or tumor\​

Seizures\​

Syncope\​

Detection of calcification\​

When magnetic resonance imaging (MRI) imaging is unavailable or contraindicated, or if the​ supervising physician deems CT to be most appropriate.​

- Standard -​

Page 792​

 

DICOM PS3.17 2020a - Explanatory Information​

Attribute​

Tag​

Value​

Potential Diagnostic​ (0018,990A)​Detect collections of blood\​

Tasks​

Identify brain masses\​

Detect brain edema or ischemia\​

Identify shift in the normal locations of the brain structures including in the cephalad or caudal​ directions\​

Evaluate the location of shunt hardware and the size of the ventricles\​

Evaluate the size of the sulci and relative changes in symmetry\​

Detect abnormal collections\​

Detect calcifications in the brain and related structures\​

Evaluate for fractures in the calvarium (skull) \​

 

Detect any intracranial air​

PredecessorProtocol​(0018,990E)​

Sequence​

 

Referenced SOP​

(0008,1150)​1.2.840.10008.5.1.4.1.1.200.1​

Class UID​

 

Referenced SOP​

(0008,1155)​9.8.7.6.5.12345.2​

Instance UID​

 

Content Creator's​

(0070,0084)​Braindoc^Barry^^^MD​

Name​

 

Protocol Design​

(0018,9910)​Tube Current Modulation (or Automatic Exposure Control) may be used, but is often turned​

Rationale​

off;​

 

According to ACR CT Accreditation Program guidelines:​

 

- The diagnostic reference level (in terms of volume CTDI) is 75 mGy.​

 

- The pass/fail limit (in terms of volume CTDI) is 80 mGy.​

 

- These values are for a routine adult head scan and may be significantly different (higher or​

 

lower) for a given patient with unique indications.​

 

NOTE: All volume CTDI values are for the 16-cm diameter CTDI phantom.​

 

Additional Resources​

 

ACR-ASNR Practice Guideline For The Performance Of Computed Tomography (CT) Of The​

 

Brain,​

 

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/CT.​

 

ACR CT Accreditation Program information, including Clinical Image Guide and Phantom​

 

Testing Instructions, http://www.acr.org/Quality-Safety/Accreditation/CT.​

Protocol Planning​

(0018,990F)​Contrast use as indicated by radiologist​

Information​

 

Instance Creation​

(0008,0012)​20150601​

Date​

 

Instance Creation​

(0008,0013)​124200​

Time​

 

InstructionSequence​(0018,9914)​

- Standard -​

 

DICOM PS3.17 2020a - Explanatory Information​

Page 793​

Attribute​

Tag​

Value​

 

>Instruction Index​

(0018,9915)​1​

 

 

>Instruction Text​

(0018,9916)​"Contrast, if directed. See Instruction Description."​

 

>Instruction​

(0018,9917)​"Someindicationsrequireinjectionofintravenousorintrathecalcontrastmediaduringimaging​

Description​

of the brain.​

 

 

 

Intravenous contrast administration should be performed as directed by the supervising​

 

radiologist using appropriate injection protocols and in accordance with the ACR Practice​

 

Guideline for the Use of Intravascular Contrast Media. A typical amount would be 100 cc at​

 

300 mg/cc strength, injected at 1 cc/sec. A delay of 4 minutes between contrast injection and​

 

the start of scanning is typical."​

 

 

Protocol Defined​

(0018,9947)​HFS​

 

 

Patient Position​

 

 

 

Patient Positioning​

(0018,991B)​

 

 

InstructionSequence​

 

 

 

>Instruction Index​

(0018,9915)​1​

 

 

>Instruction Text​

(0018,9916)​"Head in the head-holder whenever possible."​

 

>Instruction Index​

(0018,9915)​2​

 

 

>Instruction Text​

(0018,9916)​"Arms resting along body and support lower legs."​

 

>Instruction Index​

(0018,9915)​3​

 

 

>Instruction Text​

(0018,9916)​"Center table height so EAM is at center of gantry."​

 

>Instruction Index​

(0018,9915)​4​

 

 

>Instruction Text​

(0018,9916)​"Align scan to reduce lens exposure."​

 

 

>Instruction​

(0018,9917)​"To reduce or avoid ocular lens exposure, the scan angle should be parallel to a line created​

Description​

by the supraorbital ridge and the inner table of the posterior margin of the foramen magnum.​

Thismaybeaccomplishedbyeithertiltingthepatient'schintowardthechest("tucked"position)​ or tilting the gantry. While there may be some situations where this is not possible due to​ scanner or patient positioning limitations, it is considered good practice to perform one or both​ of these maneuvers whenever possible."​

Anatomic Region​ (0008,2218)​(69536005, SCT, "Head")​

Sequence​

AAAA.2.2 Scantech Industries​

The first part of this example is shown above in Table AAAA.2-1.​

Table AAAA.2-2. Routine Adult Head - Details - Scantech​

Attribute​

Tag​

Value​

Model Specification Sequence​

(0018,9912)​

 

>Manufacturer​

(0008,0070)​

Scantech​

>Manufacturer's Related Model Group​

(0008,0222)​

Scanomatic​

>Software Versions​

(0018,1020)​

VCT34​

Patient Specification Sequence​

(0018,9911)​

 

>See Table AAAA.2-2a “Patient Specification”​

 

 

Acquisition Protocol Element Specification Sequence​

(0018,991F)​

 

>Protocol Element Number​

(0018,9921)​

1​

>Parameters Specification Sequence​

(0018,9913)​

 

- Standard -​

Page 794​

DICOM PS3.17 2020a - Explanatory Information​

 

Attribute​

 

Tag​

Value​

>>See Table AAAA.2-2b “First Acquisition Protocol Element Specification”​

 

>Protocol Element Number​

 

(0018,9921)​

2​

>Parameters Specification Sequence​

 

(0018,9913)​

 

>>See Table AAAA.2-2c “Second Acquisition Protocol Element Specification”​

 

Reconstruction Protocol Element Specification Sequence​

(0018,9933)​

 

>Protocol Element Number​

 

(0018,9921)​

1​

>Parameters Specification Sequence​

 

(0018,9913)​

 

>>See Table AAAA.2-2d “First Reconstruction Protocol Element Specification”​

 

Private Data Element Characteristics Sequence​

(0008,0300)​

 

>Private Group Reference​

 

(0008,0301)​

0x0021​

>Private Creator Reference​

 

(0008,0302)​

"SCANTECH PRIVATE CT​

 

 

 

ELEMENTS"​

>Private Data Element Definition Sequence​

(0008,0310)​

 

>>Private Data Element​

 

(0008,0308)​

0099​

>>Private Data Element Value Multiplicity​

(0008,0309)​

1​

>>Private Data Element Value Representation​

(0008,030A)​

DS​

>>Private Data Element Keyword​

 

(0008,030D)​

mAsQualityPoint​

>>Private Data Element Name​

 

(0008,030C)​

mAs Quality Point​

>>Private Data Element Description​

 

(0008,030E)​

mAs Quality Point is a parameter​

 

 

 

for the proprietary tube current​

 

 

 

modulation algorithm.​

>Block Identifying Information Status​

 

(0008,0303)​

SAFE​

The following tables reflect the semantic contents of constraint sequences but not the actual structure of the IOD. The centered rows​ in italics clarify the context of the constrained Attributes that follow by indicating which sequence in the performed module contains​ the constrained Attribute (as specified in the Selector Sequence Pointer).​

Table AAAA.2-2a. Patient Specification​

Attribute​

Selector​

Selector Value​ Selector​

Selector Sequence​Constraint Type​ Constraint​

 

Attribute​

Number​

SequencePointer​ Pointer Items​

Value​

Patient's Age​

(0010,1010)​

1​

absent​

absent​

GREATER_THAN​"16Y"​

Table AAAA.2-2b. First Acquisition Protocol Element Specification​

Attribute​

SelectorAttribute​Selector​ Selector Sequence​

Selector​

Constraint​

Constraint Value​

 

 

 

Value​

Pointer​

Sequence​

Type​

 

 

 

 

Number​

 

Pointer​

 

 

 

 

 

 

 

Items​

 

 

Acquisition Protocol Element Sequence (0018,9920)​

 

 

 

 

ProtocolElementName​

(0018,9922)​

1​

(0018,9920)​

1​

EQUAL​

Localizer: Lateral​

Acquisition Type​

 

(0018,9302)​

1​

(0018,9920)​

1​

EQUAL​

CONSTANT_ANGLE​

Tube Angle​

 

(0018,9303)​

1​

(0018,9920)​

1​

EQUAL​

90​

Constant Volume Flag​

(0018,9333)​

1​

(0018,9920)​

1​

EQUAL​

NO​

Fluoroscopy Flag​

 

(0018,9334)​

1​

(0018,9920)​

1​

EQUAL​

NO​

Acquisition Motion​

 

(0018,9930)​

1​

(0018,9920)​

1​

EQUAL​

FORWARD​

>Acquisition Start Location Sequence (0018,9931)​

- Standard -​

 

 

DICOM PS3.17 2020a - Explanatory Information​

 

Page 795​

Attribute​

SelectorAttribute​Selector​ Selector Sequence​

Selector​ Constraint​

Constraint Value​

 

 

 

Value​

Pointer​

Sequence​

Type​

 

 

 

 

Number​

 

Pointer​

 

 

 

 

 

 

 

Items​

 

 

Reference Location​

 

(0018,9900)​

1​

(0018,9920),​

1\1​

EQUAL​

"Top of Skull"​

Label​

 

 

 

(0018,9931)​

 

 

 

Reference Basis Code​

(0018,9902)​

1​

(0018,9920),​

1\1​

EQUAL​

(89546000, SCT,​

Sequence​

 

 

 

(0018,9931)​

 

 

"Skull")​

Reference Geometry​

 

(0018,9903)​

1​

(0018,9920),​

1\1​

EQUAL​

(128120, DCM,​

Code Sequence​

 

 

 

(0018,9931)​

 

 

"Plane through​

 

 

 

 

 

 

 

Superior Extent")​

>Acquisition End Location Sequence (0018,9932)​

 

 

 

 

Reference Location​

 

(0018,9900)​

1​

(0018,9920),​

1\1​

EQUAL​

"256mm Inferior"​

Label​

 

 

 

(0018,9932)​

 

 

 

Reference Basis Code​

(0018,9902)​

1​

(0018,9920),​

1\1​

EQUAL​

(89546000, SCT,​

Sequence​

 

 

 

(0018,9932)​

 

 

"Skull")​

Reference Geometry​

 

(0018,9903)​

1​

(0018,9920),​

1\1​

EQUAL​

(128120, DCM,​

Code Sequence​

 

 

 

(0018,9932)​

 

 

"Plane through​

 

 

 

 

 

 

 

Superior Extent")​

Offset Distance​

 

(0018,9904)​

1​

(0018,9920),​

1\1​

EQUAL​

256​

 

 

 

 

(0018,9932)​

 

 

 

Offset Direction​

 

(0018,9905)​

1​

(0018,9920),​

1\1​

EQUAL​

INFERIOR​

 

 

 

 

(0018,9932)​

 

 

 

>CT X-Ray Details Sequence (0018,9940) - First Beam​

 

 

 

 

Beam Number​

 

(300A,00C0)​

1​

(0018,9920),​

1\1​

EQUAL​

1​

 

 

 

 

(0018,9940)​

 

 

 

KVP​

 

(0018,0060)​

1​

(0018,9920),​

1\1​

EQUAL​

120​

 

 

 

 

(0018,9940)​

 

 

 

X-ray Tube Current in​

 

(0018,9330)​

1​

(0018,9920),​

1\1​

EQUAL​

50​

mA​

 

 

 

(0018,9940)​

 

 

 

Table AAAA.2-2c. Second Acquisition Protocol Element Specification​

Attribute​

Selector Attribute​Selector​ Selector Sequence​ Selector​

Constraint​ Constraint Value​

 

 

 

Value​

Pointer​

Sequence​

Type​

 

 

 

 

Number​

 

Pointer​

 

 

 

 

 

 

 

Items​

 

 

Acquisition Protocol Element Sequence (0018,9920)​

 

 

 

 

Protocol Element Name​

(0018,9922)​

1​

(0018,9920)​

2​

EQUAL​

Helical​

Acquisition Type​

 

(0018,9302)​

1​

(0018,9920)​

2​

EQUAL​

SPIRAL​

Constant Volume Flag​

(0018,9333)​

1​

(0018,9920)​

2​

EQUAL​

NO​

Fluoroscopy Flag​

 

(0018,9334)​

1​

(0018,9920)​

2​

EQUAL​

NO​

Revolution Time​

 

(0018,9305)​

1​

(0018,9920)​

2​

EQUAL​

1.0​

Single Collimation Width​

(0018,9306)​

1​

(0018,9920)​

2​

EQUAL​

0.6​

Total Collimation Width​

(0018,9307)​

1​

(0018,9920)​

2​

EQUAL​

38.4​

Table Speed​

 

(0018,9309)​

1​

(0018,9920)​

2​

EQUAL​

21.12​

Table Speed per​

 

(0018,9310)​

1​

(0018,9920)​

2​

EQUAL​

21.12​

Rotation​

 

 

 

 

 

 

 

Spiral Pitch Factor​

 

(0018,9311)​

1​

(0018,9920)​

2​

EQUAL​

0.55​

- Standard -​

Источник: https://studfile.net/preview/14585770/

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