This is an education resource only. Ordering of all procedure codes on this website are subject to the Canberra Health Services guidelines for imaging orders.
INDICATIONS (1-4)
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Ischaemic stroke to diagnose occlusion and thrombosis / assess change and monitor known cases
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Carotid artery dissection
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Vertebral artery dissection
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Vascular malformation within the head and neck
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Transient ischaemic attack, used to evaluate carotid artery stenosis as potential causation
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Subarachnoid haemorrhage to assess aneurysmal origin
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Cerebral parenchymal haemorrhage, to assess for the presence of a vascular malformation or ongoing bleeding (spot sign)
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Follow up of known dissection & aneurysms within cerebral and neck vasculature
PATHOLOGY DEMONSTRATED (5)
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Occlusion and thrombosis within the carotid and vertebral arteries
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Carotid artery dissection
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Vertebral artery dissection
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Arteriovenous malformation within the head and neck
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Carotid artery stenosis
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Aneurysms within cerebral and neck vasculature
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Acute haemorrhage (spot sign)
PATIENT PREPARATION
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Patient able to lie still for ten minutes
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Not claustrophobic (sedation may be given)
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Cognitively capable of following basic instructions
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Metal artefacts removed from the region of interest
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No respiratory distress when lying supine
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Not allergic to Iodine based Contrast
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No known kidney disease (EGFR below 30 as per RANZCR), however, acute setting consultant may sign to continue with poor renal function
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No hyperthyroidism, may induce thyroid storm
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Patient to have 18G cannula in anterior cubital fossa to allow a 7ml/s flow rate(20G cannula acceptable if flushing to 5ml/s)
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Preferably patient fasted for 4 hours
ANATOMY INCLUDED
Angiography Arch to COW (Axial)
Angiography Arch to COW (Coronal)
Angiography Arch to COW (Sagittal)
REFERENCES
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Radiopaedia. CT Head. [Internet]. 2010 [updated 01 Dec 2021, cited 23 Nov 2021]. Available from https://radiopaedia.org/articles/ct-head
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American College of Radiology (ACR). Appropriateness Criteria. [Internet]. 2022 [Updated 2021, cited 23 Nov 2021]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria
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Radiopaedia. Brain tumours. [Internet]. 2008. [updated 18 Dec 2019, accessed 23 Nov 21]. Available from https://radiopaedia.org/articles/brain-tumours
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Radiopaedia. Skull Fractures. [Internet]. 2017 [updated 19 Sep 2021, cited 23 Nov 2021]. Available from https://radiopaedia.org/articles/skull-fractures
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Eisenberg RL., Johnson NM. Comprehensive Radiographic Pathology. 5th Edition. Elsevier Mosby, 2012.