CT Head Perfusion With IV Contrast CT head perfusion imaging may help delineate the hemodynamic significance of a known asymptomatic carotid lesion and the collateral support in each distribution. More specifically, perfusion imaging may be helpful in cases of moderate stenosis, approaching 70% or severe stenosis [124]. However, there is no literature to support the use of CTP as the initial imaging test in surveillance imaging of asymptomatic carotid disease. The need for IV contrast and relative lack of sensitivity for white matter ischemic changes detracts from the routine use of this study in surveillance imaging. CT Head With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT of the head in the surveillance imaging of asymptomatic carotid stenosis. CT Head Without and With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT of the head in the surveillance imaging of asymptomatic carotid stenosis. CT Head Without IV Contrast There is no literature to support noncontrast CT of the head in the routine surveillance imaging of asymptomatic carotid disease. Noncontrast CT of the head is useful in evaluating for the sequela of carotid stenosis such as clinically silent strokes or microvascular ischemic changes in the setting of an established diagnosis of carotid stenosis, which is particularly important in cases of hemodynamically significant stenosis. However, MRI is much more sensitive in evaluating microvascular ischemic changes or recent strokes. Symptomatic carotid disease should be evaluated relative to the underlying symptoms. Please see Variants 1 to 5 for a discussion of appropriate imaging. CTA Head With IV Contrast There is no literature to support CTA of the head in routine surveillance imaging of known asymptomatic carotid disease with no future treatment plans.
Cerebrovascular Diseases Stroke and Stroke Related Conditions PCAs. CT Head Perfusion With IV Contrast CT head perfusion imaging may help delineate the hemodynamic significance of a known asymptomatic carotid lesion and the collateral support in each distribution. More specifically, perfusion imaging may be helpful in cases of moderate stenosis, approaching 70% or severe stenosis [124]. However, there is no literature to support the use of CTP as the initial imaging test in surveillance imaging of asymptomatic carotid disease. The need for IV contrast and relative lack of sensitivity for white matter ischemic changes detracts from the routine use of this study in surveillance imaging. CT Head With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT of the head in the surveillance imaging of asymptomatic carotid stenosis. CT Head Without and With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT of the head in the surveillance imaging of asymptomatic carotid stenosis. CT Head Without IV Contrast There is no literature to support noncontrast CT of the head in the routine surveillance imaging of asymptomatic carotid disease. Noncontrast CT of the head is useful in evaluating for the sequela of carotid stenosis such as clinically silent strokes or microvascular ischemic changes in the setting of an established diagnosis of carotid stenosis, which is particularly important in cases of hemodynamically significant stenosis. However, MRI is much more sensitive in evaluating microvascular ischemic changes or recent strokes. Symptomatic carotid disease should be evaluated relative to the underlying symptoms. Please see Variants 1 to 5 for a discussion of appropriate imaging. CTA Head With IV Contrast There is no literature to support CTA of the head in routine surveillance imaging of known asymptomatic carotid disease with no future treatment plans.