CT Protocols: (Brain, ENT, Spine, Vascular) - Department of Radiology

Appendix # 2
129 Revised 7/22/09 (Gentry/Ranallo)
CTA Neck: 3D Vascular Analysis and 2D-Reformations
A. 3D Analysis through the vertebral and carotid arteries
1. For each carotid bifurcation, calculate the percent stenosis (NACET) using Vitrea
2. Do 1 mm by 1 mm curved reformations through any vessel that has been previously stented
3. Send all images to ALI Store.
B. Do 2D-Reformations through the vertebral and carotid arteries
1. Use an axial image near the level of the hyoid bone at the carotid bifurcation to prescribe the correct
oblique angles. Use an image that shows the external and internal carotid arteries.
2. Choose only the axial images from the aortic arch to the EAC.
3. Use a window width 800 and window level 200
4. Bilateral oblique sagittal 2D reformations: Do 2 mm X 2 mm reformations thru each carotid bifurcation.
Angle so that the reformations go through both the external and internal carotid arteries. (See below)
5. Coronal 2D reformations: Do 2 mm X 2 mm reformations thru both sides at the same time. Include both
the carotid and vertebral arteries (See example below)
6. Send to 3D Lab for Intravascular Analysis of the carotid bifurcations (i.e. severity of carotid stenosis).
7. Send all images to ALI Store.
8. All patients should have a duplicate request made, write duplicate on it, put the duplicate request in the 3D
box, all remaining requests go to the neuro reading room.
Oblique Sagittal 2D-Reformats
Through Carotid Bifurcations
Coronal 2D-Reformats
Through Carotid Bifurcations