Imaging

Cavernoma protocol MRI: MRI Brain w/wo include in comments "T1 thin cuts PRE and POST contrast"

There is no MRV order

order a MRA Brain and specify VENOGRAM in all caps in the special instructions

MRA

- this is NOT a contrasted study, just a "Time of flight"

• good for evaluating dissections
• not good for evaluating aneurysms 4mm or less  

CT Brain Perfusion

- this requires iodine contrast
- choose areas of interest in non-con scan 
- inject at standard rate 40 mL IV at 5mL / sec 

There is no CTV order

order a CTA Brain and specify VENOGRAM in all caps in the special instructions 

CT angiography

* rapid injection of iodinated contrast at 3-4 cc/sec (Isovue 300)

• must be thin cut
• must include tip of nose. 

Okonkwo often gets these

Order = MRI cervical spine without contrast

specify in instructions: "flexion and extension" 

Note: 

they will not do a neutral spine MRI unless you specify

they will not do axials unless you specify 

Order: CT head non-contrast w/ special comments: dual energy CTH 

generally needed within __ hours after contrast administration 

"CISS/FIESTA sequences in all 3 planes + CINE FLOW sequence to evaluate ETV patency"