Interactive Transcript
0:01
How do we image the carotid space?
0:03
For the most part,
0:04
we're going to be using contrast-enhanced CT scan
0:07
and we're going to be acquiring with thin sections
0:09
so that way we can do multiplanar reconstructions.
0:13
On some of the cases where the pathology
0:15
is in the blood vessels,
0:17
for example, the arteries or the veins,
0:19
we will use a CTA or CTV technique timed
0:24
to the bolus of the contrast.
0:26
Often we will be using three-dimensional
0:28
reconstructions,
0:29
particularly when we're doing presurgical evaluation
0:32
of a lesion in the carotid space.
0:35
On MRI, we're using our neck protocol.
0:38
The neck protocol requires you to have very
0:41
good fat suppression techniques. For some,
0:44
that can be using frequency selective fat
0:48
suppression techniques. But for most people,
0:50
they use inversion recovery fast spin echo T2-weighted scans
0:54
in order to invert at the fat
0:57
frequency and cause the neck to have dark.
1:01
Signal T1-weighted scans without fat suppression
1:05
are excellent because the fat that is bright on a T1-weighted scan provides excellent contrast with
1:08
which to see an intermediate
1:12
signal intensity lesion.
1:14
We do post-gadolinium enhanced scanning
1:18
in the MR sequences,
1:21
again using fat suppression in order to highlight
1:24
whether a lesion is enhancing or not.
1:27
If the lesion is small or at the skull base,
1:30
we will convert the study into
1:31
our skull-based protocol,
1:33
which uses thin section Fiesta or CIS imaging.
1:37
That's the very high-resolution T2-weighted
1:42
sequencing. Or we'll use the Vibe imaging,
1:45
which is analogous thin section
1:47
T1-weighted imaging. Again,
1:56
and the pathology. Therefore, make sure that
1:59
you're using whatever fat suppression technique,
2:02
be it Dixon,
2:04
be it inversion recovery or frequency selection
2:07
that works best on your scanner.
© 2024 MRI Online. All Rights Reserved.