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CT scans are used to detect and monitor many types of diseases. CT Angiograms are a specific type of CT scan that uses dye injected a high rate to evaluate the arteries of your body. Carotid CT Angiograms evaluate the vessels of the neck to look for aneurysms, vascular tumors, narrowing and blockage of the vessels of the neck, among others.

This CT scan uses special software to create realistic 3D images and gives the Radiologist interpreting the test the ability to look inside the vessels.

CT angiograms of the carotids are typically ordered for the evaluation of stroke to detect blockages and narrowing of the arteries in the neck caused by plaque that ultimately supply the brain. Symptoms related to stroke include:

• weakness
• sudden speech difficulties
• confusion, erratic behavior
• vertigo, dizziness
• pain, tingling
  
• numbness

CT Angiograms can diagnose:

Plaque - CT Angiograms of the carotids can detect soft and hard plaque deposits that overtime narrow the opening of the vessel leading to reduced blood flow to the brain. Some plaque can abruptly "tear" off sending bits of plaque into the brain, blocking small vessels. Sometimes these tiny blockages can be completely unnoticed and other times cause the symptoms of stroke. In some cases the vessel can narrow to a point and cause a rushing sound in the neck called a "bruit." The sound is blood trying to get through the narrow opening.

Dissection - This refers to a tear in the wall of the vessel. Think of it as a tear of the inner lining of the sleeve of a jacket. If you filled the inner lining of your jacket with down it would block the real opening for your arm.  In the artery the blood goes into the opening of the tear of the dissection, expands the false channel, potentially blocking the flow of blood to the brain and resulting in stroke like symptoms.

Aneurysms and Vascular Tumors - Aneurysms are ballooning of the vessels that can either disturb normal blood flow or by their shape and size press on nearby tissues and cause related symptoms such as neck pain, pressure, nerve blockage, etc. Vascular tumors may be picked as the vessels that feed them are large enough to be seen on a CT angiogram.

A CT Angiogram of the Carotids will evaluate:

Internal Carotid Arteries

The carotid vessels arise from the aorta in the chest and travel up the neck along both sides. The vessels splits in the neck with the "internal" segments feeding roughly the front 2/3 of brain tissue. The "external" segments feed the face and parts of the scalp and skull.

Vertebral and Basilar Arteries

The basilar artery is made up by two vertebral arteries which arise from vessels in the chest and travel up along both sides of the neck near the spine. This vessel feeds the brain stem and approximately the back 1/3 of the brain.

Aortic Arch

Neck soft tissues

Parts of the soft tissues of the neck are seen in a CT angiogram of the carotids. Occasionally large tumors, inflammation or other findings can be picked up. 

Your CT Angiogram of the Carotids:

This CT scan generally takes about 15 minutes or so to set up and complete. This test is always done with IV MRI contrast. Keep in mind that the dye is injected at a much higher rate than a standard CT. Therefore a larger IV is used for this test. Many patients feel sudden flashes of heat and a metallic taste in their mouth. You may also feel sudden warmth in your bladder.

If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an CT Angiogram of the carotids, you can use our website to look up CT Angiogram costs and then purchase with your credit card.

Have you had a Carotid CT Angiogram scan? What was it like? Please leave your comments below.

MRI scans are frequently used to evaluate the internal structures of the brain. Pituitary gland MRIs are used to discover tumors of the pituitary gland. FYI a pituitary MRI is also sometimes called a sella MRI.

In the picture to the right the pituary gland is the gray structure sitting in the white bone. You can see the thin stalk connecting it to the brain.

Your pituitary gland secretes many different kinds of hormones. Pituitary tumors can either destroy normal hormone secreting cells or create excessive hormones. Pituitary tumors can cause symptoms such as tiredness, headache, nipple discharge, excessive growth, and thirst. Some of the larger tumors can also press against nearby structures such as your optic nerves and affect your vision.

An MRI of the pituitary gland will look for:

Microadenoma - These are tiny (less than 10 mm in size) tumors that are usually suspected because they secrete a hormone such as prolactin for example. Prolactin causes milky nipple discharge.

Craniopharyngioma - These pituitary tumors are generally found in young children and cause symptoms related to their size. They press on the optic nerves causing vision symptoms and compress nearby brain and can cause hydrocephalus leading to headaches.

Cysts - Most pituitary cysts are asymptomatic and small. But some large cysts can act like tumors in that they press on nearby brain structures and cause symptoms such as headache.

Apoplexy - Some pituitary tumors can bleed and destroy much of the pituitary gland causing severe hormone imbalances. Or if the pituitary gland loses its blood supply it will result in a similar set of symptoms. This condition is called pituitary apoplexy and can be life threatening. The MRI will look for blood or tissue death in the pituitary gland.

An MRI of the pituitary gland (sella) will evaluate:

Pituitary gland

The pituitary gland is a pea sized structure in the middle of your brain just behind your eyes. It sits inside a bone cavity called the  sella dorsica. The gland is attached to the brain by a thin stalk called the infundibulum. 

Orbits

Although Pituitary MRIs are not tailored to look at the orbits, parts of the visual pathways are included as large pituitary tumors can compress the optic nerves (optic chiasm) and cause visual symptoms.

Bones

Brain matter

Parts of the white and gray matter of the brain are  seen. MRI can detect tumors, infection, bleeds, and stroke. Since some pituitary tumors grow and expand into the brain, the nearby brain structures are always included in the study.

Your Pituitary Gland MRI Scan

A pituitary MRI generally takes about 30 minutes or so to complete. If you are going for one, wear loose comfortable clothing and remember to remove all metal (jewelry, phones, rings, etc) before going into the MRI scan room. This test is nearly always done with IV MRI contrast.

If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an MRI scan of the pituitary gland, you can use our website to look up MRI scan costs and then purchase with your credit card.

Have you had a Pituitary MRI scan? What was it like? Please leave your comments below.

We're very excited to announce a new relationship with one of the largest Radiology networks in the US. As of now RemakeHealth will use the One Call Medical network for all of its Radiology services which will include MRI, CT, PET, and PET/CT scans.

This will allow RemakeHealth to expand its reach and offer health care consumers personalized services.

RemakeHealth now offers you

• Greater savings on MRI, CT and PET scans
• Same 100% refund policy
  
• More Radiology facilities across the US
• You choose the best price, closest facility
  
• Call center office staffed M-F 8a to 8p EST
  

Each facility in the One Call Medical network is accredited by the NCQA guidelines, features American Board of Radiology certified Radiologists and has undergone a rigorous selection process.

More about One Call Medical

• Offers significant discounts for MRI, CT and PET scan
  
• Scheduled over 330,000 exams in 2007
• Has 2900 Radiology facilities in its network
• Multilingual call center staff
  

You can read more about One Call Medical here.

Please pardon our mess as we upgrade the site and clean up bugs! 

Are there any other services you'd like us to add? Please leave your suggestions below:

MRI scans are frequently used to evaluate the internal structures of the brain and nearby structures. Orbit MRIs are used to discover tumors, infection and chronic diseases that affect the structures in and around the orbits.

Orbit MRIs are nearly always done as a with and without contrast exam. That is, first the MRI is done without the dye injection and then images are taken after the dye has been administered by IV. Below are a few common conditions that Orbit MRIs can evaluate.

Tumor - Tumors can be primary (from the eye) or secondary (from other sites, eg melanoma). These typically present with eye pain, double vision, or are picked up during an eye exam.

Infection - Orbit infections present with eye pain, double vision, watery eyes and swelling of the tissues around the eyes. Some inflammatory conditions affect the eye itself whereas others may affect the lacrimal gland (makes tears) or the fat that surrounds the eyeball. Orbit MRIs are also very good at evaluating the nearby bones for infection (called osteomyelitis).

Optic Neuropathy - The optic nerve carries light signals from the retina (back of the eye) to the brain. Think of it as a cable filled with signals. If this is damaged or deteriorates, an Orbit MRI can pick up changes to the nerve. Damage to the optic nerve can appear as either thickening or thinning of the nerve.

Other conditions - Orbit MRIs can pick up papilledema (swelling head of the optic nerve), enlarged eye muscles (seen in thryoid conditions), infection or tumors of the lacrimal gland and enlargement of vessels that supply and drain the eye area.

An MRI of the Orbits will also partially evaluate:

Sinuses

An Orbit MRI will include parts of the sinuses. Though not used to primarily look for sinus disease, an MRI can see thickening of the sinus tissue (mucosa) or fluid in the sinuses.

Bones

Brain matter

The white and gray matter of the brain are also partially seen. MRI can detect tumors, infection, bleeds, stroke and congenital defects. The pituitary gland and upper brainstem are also evaluated.

Your Orbit MRI Scan

An Orbit MRI generally takes about 30-45 minutes or so to complete. If you are going for one, wear loose comfortable clothing and remember to remove all metal (jewelry, phones, rings, etc) before going into the MRI scan room. This test is nearly always done with IV MRI contrast.

If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an MRI scan of the orbit, you can use our website to look up MRI scan costs and then purchase with your credit card.

Have you had an Orbit MRI scan? What was it like? Please leave your comments below.

Ultrasound tests use sound waves to create images of the internal organs. Breast ultrasounds are frequently ordered to evaluate new breast masses, cysts, nodules or suspicious findings on a mammogram. They can also be used to follow up unusual mammographic findings that are not clearly cancerous over time or help in breast tissue biopsies.

In the breast ultrasound picture to the right, the breast tissue is the gray speckled tissue around the black "hole". The "hole" is a cyst filled with fluid.

Many breast ultrasound exams are ordered during or after a mammogram. On occasion, when a mammogram does not show a lump that you or your doctor felt, ultrasound is used to further examine the tissue.

Your doctor's order may read "r/o nodule", "r/o tumor" or "follow up mammogram", for example.

(FYI "r/o" stands for rule out)

Remember if you are going for a breast ultrasound be sure to bring your mammogram films (most recent and previous) with reports if you had these done at a different facility.

Below are some common uses for breast ultrasounds.

• Examine new nodules felt during a physical exam
• Evaluate for suddenly growing nodules of the breast
  
• Evaluate suspicious findings on a mammogram such as a nodule, mass or scarring
• Follow up nodules or cysts that are not clearly cancerous
• Use ultrasound to help guide a biopsy of a breast mass or drain a cyst

Below is a brief outline of the procedure.

1. After you sign in to the Radiology office, you'll be taken to the ultrasound room.  Be sure to have your mammogram with you if it was done at a different facility.
2. An ultrasound technician will perform the test.
3. The technologist will ask you to remove your shirt, bra and change into a gown.
4. Once the technologist returns, you will lie down on a bed/gurney.
5. He or she will place a a warmed gel solution over the skin of your breast.
6. The technologist will use an ultrasound probe and glide it over the breast and take pictures.
7. The technologist may ask the Radiologist doctor to review the scan before you leave.
8. An official report is generated by the Radiologist in about 24-48 hours.

If you are insured breast ultrasounds are covered. However, for uninsured patients these tests can be quite expensive. You can expect to pay anywhere between $150 to $300 for this test.

Have you had a breast ultrasound? What was it like? Please leave your comments below:

Whole body scanners are fast becoming a common screening tool in airports to detect items hidden by clothing.  One of the key concerns air travelers have is the radiation exposure from these screening scanners. There are two types of scanners currently in use at airports in the U.S.

Millimeter wave (MMW) technology uses low energy radio-frequencies which creates 3-D outlines of the body to reveal items hidden by clothing. MMW can detect both metallic and non-metallic items.

Backscatter machines use low-dose X-rays to create high quality pictures that can reveal items under and in clothing.

According to a recent statement released by the American College of Radiology (www.acr.org) the level of radiation passengers are exposed to is extremely low:

"An airline passenger flying cross-country is exposed to more radiation from the flight than from screening by one of these devices. The National Council on Radiation Protection and Measurement (NCRP) has reported that a traveler would need to experience 100 backscatter scans per year to reach what they classify as a Negligible Individual Dose. The American College of Radiology (ACR) agrees with this conclusion. By these measurements, a traveler would require more than 1,000 such scans in a year to reach the effective dose equal to one standard chest x-ray."

The Health Physics society estimates that a backscatter scan delivers a dose of .005 millirems.  American Science and Engineering Inc, estimates the dose to be .009 millirems. To put these numbers in context, compare radiation doses below from everyday life and common sources:

• Transcontinental flight - 4 mrem
• 2 days in Denver -  1 mrem
• Chest X-ray - 10 mrem
• 1.5 packs of cigarettes per day - 1300 mrem per year
  
• Watching TV - 30 mrem per year
• Airport screening scan - 0.009 mrem per scan

What are your thoughts? Please leave your comments below:

Ultrasound tests use sound waves to create images of the internal organs. Carotid ultrasounds are usually ordered to evaluate the flow in the vessels of your neck that supply blood to your neck, face and brain.

In the carotid picture to the right, the vessel is the tubular structure that is filled with color. The color is the ultrasound machine's intrepretation of the flow of blood. The gray wave at the bottom is the pulsation of the vessel.

Your carotid arteries are located along the sides of your neck.  If you have atherosclerosis (aka plaque formation) of your vessels it will show up as areas of narrowing or irregularity. Plaque can result in stenosis (aka narrowing) of the vessel which can lead to decreased flow to the brain for example.

Plaque can also completely block the flow of blood. Some patients with blocked vessels may have no to few symptoms because the blockage has occurred slowly over time and they have collateral vessels that bypass the blockage and supply blood to critical brain structures. However, other patients may exhibit symptoms such as small strokes, dizziness, vertigo, passing out etc. Plaque can also break off and travel up into the brain and cause a stroke.  

Your doctor's order may read "r/o stenosis", "h/o TIA" or "stroke", for example.

(FYI "r/o" stands for rule out, "h/o" stands for history of, and TIA is transient ischemic attack)

Below are some common indications for carotid ultrasounds.

• Examine vessels for narrowing due to symptoms related to stroke, narrowing or blockage
• Examine the vessels due to comorbid medical conditions such as diabetes, high cholesterol or family history of stroke
• Evaluate the vessels because of a bruit (rushing, whistling noise) of the vessels heard during a physical exam
• Preoperative evaluation for carotid or other vascular surgery such as heart surgery
• Follow up carotid surgery and evaluate for any progression/worsening of narrowing
• Look for injury to the vessel (dissection, hematoma, etc)

Below is a brief outline of the procedure.

1. After you sign in to the Radiology office, you'll be taken to the ultrasound room.
2. An ultrasound technician will perform the test.
3. Once you enter the room, you will lie down on a bed/gurney.
4. The technologist will ask you to pull down your collar or loosen your shirt.
5. He or she will place a a warmed gel solution over the skin of your neck.
6. The technologist will use an ultrasound probe and glide it over the neck and take pictures.
7. You may be asked to turn your head for the technologist to get a better look at the vessels in the neck.
8. The technologist may ask the Radiologist doctor to review the scan before you leave.
9. An official report is generated by the Radiologist in about 24-48 hours.

If you are insured carotid ultrasounds are covered. However, for uninsured patients these tests can be quite expensive. You can expect to pay anywhere between $300 and $700 for this test.

Have you had a carotid ultrasound? What was it like? Please leave your comments below:

Ultrasound tests use sound waves to create images of the internal organs. Thyroid ultrasounds are frequently ordered to evaluate new nodules or suddenly changing nodules, large thyroid glands or abnormal thyroid function tests.

In the thyroid gland picture to the right, the thyroid gland is the gray speckled tissue on either side and above the black hole (which is your trachea filled with air). The two other black holes on the left and right underneath the thyroid tissue are vessels.

Your thyroid gland is located just below your Adam's apple and is vital in producing hormones such as T4 and T3. People with overactive thyroid gland - called hyperthyroidism -  have symptoms related to racing heartbeats, sweating, tremors, thinning hair, losing weight, bulging eyes. Those with under active thyroid gland - called hypothyroidism -  experience weight gain, tiredness, feel cold, and may have dry skin, among other symptoms.

Your doctor's order may also read "r/o nodule", "r/o tumor" or "enlarged thyroid", for example.

(FYI "r/o" stands for rule out)

Below are some common uses for thyroid ultrasounds.

• Examine new thyroid nodules felt during a physical exam.
  
• Evaluate for suddenly growing nodules of the thyroid 
• Evaluate enlarged thyroid gland
• Examine the thyroid if it is not functioning properly (either under or overactive)
  
• Use ultrasound to help guide a biopsy of a thyroid nodule or mass

Below is a brief outline of the procedure.

1. After you sign in to the Radiology office, you'll be taken to the ultrasound room.
2. An ultrasound technician will perform the test.
3. Once you enter the room, you will lie down on a bed/gurney.
4. The technologist will ask you to pull down your collar or loosen your shirt.
5. He or she will place a a warmed gel solution over the skin of your neck.
6. The technologist will use an ultrasound probe and glide it over the neck and take pictures.
7. You may be asked to turn your head for the technologist to get a better look at the edges of the thyroid and nearby tissues.
8. The technologist may ask the Radiologist doctor to review the scan before you leave.
9. An official report is generated by the Radiologist in about 24-48 hours.

If you are insured thyroid ultrasounds are covered. However, for uninsured patients these tests can be quite expensive. You can expect to pay anywhere between $200 and $500 for this test.

Have you had a thyroid ultrasound? What was it like? Please leave your comments below: