MRA

Table of Contents

Page No.

Carotids 3-5

Circle of Willis 6-7

Posterior Circulation 8-9

Sagittal Sinus 10-11

Carotids

A. Clinical Indications

1. Carotid stenosis

B. Patient Preparation

1. Routine brain MRI scan

C. Patient Positioning

1. Head and neck coils

2. Head first

3. Supine

4. Center at glabella for Circle of Willis

5. Center at lips for coronal scans

6. Center at Adam's apple for neck coil scans

D. Scanning Sequences

Anatomy Head neck

Angio

C.O.W. (head coil)

____ survey

____ 3D C.O.W.

____ 3D PCA COR

____ 2D TRA

____ 3D TRA

see attached sheets

Carotids (continued)

E. Filming: MIP Scan

1. Circle of Willis

A ® L

® 10° ¬

H ® P

® 10° ¬

2. Bilateral carotids and vertebrals (coronal scan)

A ® L

® 10° ¬

3. 2D and 3D carotid bifurcation

Right side: A ® L

ï ¯

ï

ï 18°

ï

ï

Left side A ® L

¯ ï

ï

18° ï

ï

ï

4. Magnify Circle of Willis AÆ L and H Æ P images using the same mag factor.

5. Magnify coronal images

6. Magnify 2D images using the same mag factor for each side. (Mag factor should not be greater than 2)

7. Magnify 3D images using the same mag factor for each side.

Circle of Willis

A. Clinical Indications

1. Severe headache

2. Aneurysm

3. Vasculitis

B. Patient Preparation

1. Routine brain MRI scan

C. Patient Positioning

1. Head coil

2. Head first

3. Supine

4. Center at glabella

D. Scanning Sequences

Anatomy Head neck

Angio

____ survey

____ 3D C.O.W.

see attached sheets

Circle of Willis (continued)

E. Filming: MIP scan:

A ® L

® 10° ¬

H ® P

® 10° ¬

Note: Magnify images using the same mag factor

Posterior Circulation

A. Clinical Indications

1. Vertebro-basillar insufficiency/infarct

B. Patient Preparation

1. Brain stem MRI scan

C. Patient Positioning

1. Head coil

2. Head first

3. Supine

4. Center at glabella

D. Scanning Sequences

Anatomy Head neck

____ survey

____ 3D C.O.W./VERT

see attached sheets

Posterior Circulation (continued)

E. Filming

1. MIP carotids and posterior circulation vessels:

A ® L

® 10° ¬

H ® P

® 10° ¬

2. MIP posterior circulation vessels only:

H ® P

® 18° ¬

Note: Magnify images with factor not greater than 2.

Sagittal Sinus

A. Clinical Indications

1. Sagittal sinus thrombosis

2. Severe headache

3. Para-sagittal, cortical infarcts

4. Para-sagittal meningioma

B. Patient Preparation

1. Routine brain MRI scan

C. Patient Positioning

1. Head coil

2. Head first

3. Supine

4. Center at glabella

D. Scanning Sequences

Anatomy Head neck

Angio

____ survey

____ 2D sag/sinus

see attached sheets

Sagittal Sinus (continued)

E. Filming: MIP scan:

A ® L

® 10° ¬

H ® P

® 10° ¬

Note: Magnify images using the same mag factor