Vascular Imaging Clinical Protocols: Routine Neck Arch














New York University School of Medicine Department of Radiology
Suggestions/Comments

Vascular Imaging Clinical Protocols

Routine Neck Arch with Contrast

Last updated: 1/22/2002

Coils: neck coil (position the patient as far into the coil as he/she will go so we can try to image the arch).

20cc Gadolinium contrast (*)

EKG Leads

Assess the patient’s breath holding capability. If poor capability, give oxygen. If pt can’t hold his/her breath call body radiologist.

Call body radiologist.

Sequence	Plane	Comment	Film #
DB Haste	Ax	Extend thru chest (phase encoding A-P)	2
Sat down	Ax		1
2D TOF	Ax	To cover carotid bifurcation.	0
3D FLASH	Straight Sag	1 measure. Use small FOV. 512 or 256 matrix. Try to minimize actual effective thickness (as small as 1mm) If attention to vertebral arteries use a coronal slab.	0
Timing Run	Ax	Thru mid neck – 1cc of contrast at 2cc/sec followed by 20 cc saline at 2cc/sec.	0
3D FLASH	Sag	2 measures (7 sec gap; 2^nd run may be done on inspiration) Inject 20cc of Gd at 2cc/sec followed by 20cc saline at 2cc/sec. Standard timing formula.	0
MIP		Subtract if necessary. Do bilateral, as well as right and left sides separately.	2
VIBE	Ax	1 measure (through chest)	1

Assess coverage of the arch on the post-contrast 3D. If the origins of the great vessels are not adequately imaged, reposition the patient with the phased array coil over the chest and do a second injection.

NOTE: In case of suspected dissection, add axial T1 TSE.

(*) The use of gadolinium contrast material for these applications represents off-label usage in the U.S. Outside the U.S., please consult your country's regulations for local guidelines.

NOTE: These protocols apply to Siemens Symphony (with Quantum gradients) and Sonata systems. While they reflect the protocols used at NYU Medical Center, NYU is not responsible for their application elsewhere.