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Referring physician ordering guide what to order when

Referring Physician Ordering Guide What to Order When The radiologists at Radia have developed the following scanning guidelines for our referring providers to assist you in selecting the most e ?ective imaging modality for your patient ? s clinical presentation This booklet is intended only as a guideline To schedule a study or consult with a radiologist please call - - Neuroradiology Ordering Guidelines Brain Indication Headache Trauma Suspected intracranial hemorrhage Acute neurological changes Acute stroke TIA Hydrocephalus Seizure Temporal lobe epilepsy Dementia Memory loss Preferred Study CT head without contrast for acute ??worst headache of life ? MRI without contrast CT head without contrast acute Concussion TBI MRI without and with contrast with DTI CT head without contrast CT head without contrast only if concern for ICH Subsequent study MRI with and without contrast CT head without contrast if candidate for thrombolysis Subsequent studies MRI brain with without contrast with MR perfusion MRA brain and MRA neck without and with contrast as indicated If concern for shunt malfunction CT head without contrast Alternative for more acute processes MRI with and without contrast First New Onset seizures MRI Brain with and without contrast CT Head if patient unstable concern for ICH MRI without and with contrast with hippocampal volumes Brain SPECT as needed MRI brain with without contrast Hippocampal volumetrics Alzheimer ? s disease perfusion aqueductal stroke volume measurement NPH PET can also be considered for Alzheimer ? s diagnosis www radiax com Toll Free - - CNormal pressure hydrocephalus aqueductal stenosis Chiari I malformation Mass Aneurysm or AVM Infection CSF leak Cranial neuropathy Pituitary dysfunction Face Indication Trauma Sinus disease Infection Hearing loss vertigo TMJ pain Possible metal in orbits and patient needs an MRI Neck Soft Tissue Indication Carotid or vertebral artery stenosis Mass Infection Neurologic de ?cit in brachial plexus Carotid or vertebral artery Dissection Thoracic Spine Indication Trauma Brain MRI without contrast CSF ow study Acqueductal stroke volume measurement MRI without and with contrast MRI contraindicated CT without and with contrast ??Screening ? MRA Head non-contrast T CTA head with contrast for de ?nition of small aneurysms patients who can ? t get MRA Follow-up studies MRA T MRI without and with contrast MRI contraindicated CT without and with contrast CT Cisternogram requires intrathecal contrast injection i e identical to myelogram Nuclear medicine CSF leak study MRI without and with contrast Cranial nerve protocol MRI Brain with and without contrast Pituitary protocol Preferred Study CT maxillofacial without contrast CT sinus without contrast If suspected orbital intracranial involvement MRI Brain and Orbits without and with contrast CT maxillofacial with contrast Suspected orbit or brain extension MRI Brain and Orbits without contrast IAC protocol Developmental CT temporal bones without contrast Sensorineural MRI IAC without and with contrast MRI temporomandibular joints Orbits x-ray Preferred Study CTA neck with contrast MRA neck without and with contrast Carotid Doppler ultrasound CT neck with contrast Thyroid nodule neck ultrasound Thyroid cancer MR neck without and with contrast CT neck with contrast MRI