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CTA Head and Neck (Arch to Vertex)

Last Updated: 2026-01-04
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  • 1. Clinical Summary

    Series Phase Coverage
    CTA Neck Arterial (bolus tracked) Aortic arch to Skull base
    CTA Head Contrast (Immediate delay) Skull base to Vertex
    • Stroke workup
    • Carotid stenosis
    • Vertebral artery dissection
    • Aneurysm screening

  • 2. Patient Prep

    • Position: Supine head-first with arms at sides
    • NPO Status: NPO 2 hours
    • Pre-Medication:
      • None typically. Consider anxiolytic if severe claustrophobia

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 80-100 mL
    Flow Rate 4-5 mL/s
    Timing Method Bolus Tracking
    ROI Placement Aortic arch
    Trigger (HU) 150 HU

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • Scan from aortic arch through vertex. Use bolus tracking in arch. Minimize dental artifact with gantry angulation
    • Additional Recons: MIP and 3D VR reconstructions of vessels. Curved MPR of carotids
    • Good antecubital IV access required - 20G minimum. Verify injection site for extravasation risk

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history and renal function
    • Evaluate complete circle of Willis. Assess carotid bifurcations. Look for dissection. Check aneurysms
    • Remove dentures. Minimize swallowing during neck acquisition
Series Name Start Location End Location Delay Slice Thickness Notes
Scout/Topogram Aortic arch Vertex N/A N/A AP and lateral
CTA Neck Aortic arch Skull base Bolus tracked 0.625 mm Arterial phase - caudocranial
CTA Head Skull base Vertex Immediate 0.625 mm Same bolus as neck - single acquisition
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial CTA Neck 1 mm/1 mm Vascular 3 Submillimeter for carotid assessment
Axial CTA Head 1 mm/1 mm Vascular 3 Submillimeter for circle of Willis
Coronal CTA Neck 2 mm/2 mm Vascular 3 MIP for carotid overview
Sagittal CTA Full 2 mm/2 mm Vascular 3 MIP for vertebral arteries