Brain

Carotid Intima-Media Thickness(CIMT) Ultrasound

Measurement of carotid intima-media thickness (CIMT) in the carotid artery with an ultrasound is a non-invasive, sensitive, and reproducible technique for identifying and quantifying subclinical vascular disease and for evaluating Cardiovascular Disease (CVD) risk – heart attacks and strokes and also to predict future cardiovascular disease (heart attacks and strokes) risk.

  • Patients at intermediate CVD risk (i.e. 6%-20% 10-year risk for myocardial infarction or coronary heart disease death who do not have established coronary heart disease or coronary disease risk equivalent conditions)
  • Family history of premature coronary heart disease (heart attacks and strokes) in a first-degree relative; 
  • Younger than 60 years old with severe abnormalities in a single risk factor who otherwise would not be candidates for pharmacotherapy;
  • Women younger than 60 years old with at least two coronary heart disease risk factors.
  • If the level of aggressiveness of therapy is uncertain and additional information about the burden of subclinical vascular disease or future coronary heart disease (heart attacks and strokes) risk is needed.
  • Reclassify patients at intermediate risk, discriminate between patients with and without prevalent coronary heart disease, and predict major adverse coronary heart disease (heart attacks and strokes) events.
  • Hypertension
  • Diabetes
  • Raised total cholesterol, raised triglycerides, raised LDL cholesterol, raised ratio total cholesterol/HDL and reduced HDL cholesterol
  • Overweight and obesity
  • Smoking
  • Male above 35 years old and post menopausal women.
  • Family history of heart attacks and stroke.
  • Medical history of arrhythmias (irregular heart beat)
  • Transient Ischemic Attack (TIA)- minor stroke
  • Peripheral Arterial Disease (PAD) – narrowing or blockages of arteries in the legs.

Atherosclerotic vascular disease begins in childhood and progresses over decades.

Symptomatic, clinical cardiovascular disease (CVD) events generally occur when atherosclerosis progresses to flow limiting disease that causes ischemia, or when a thrombus forms on an existing plaque as a result of rupture or erosion.

Although not everyone with underlying atherosclerotic plaque will experience a clinical CVD event, the greater the degree of subclinical atherosclerosis, the greater the risk for future cardiovascular events.

To prevent death and morbidity from CVD, there is great interest in identifying asymptomatic patients at high risk who would be candidates for more intensive, evidence-based medical interventions that reduce CVD risk.

Imaging of carotid arteries using CIMT study to identify and quantify thepresence of subclinical vascular disease has been suggested to further refine CVD risk assessment.

As a screening test, imaging must be safe, be sensitive, be affordable, and lead to interventions that can favourably alter the natural history of CVD.

Measurement of carotid intima-media thickness (CIMT) with B-mode ultrasound is a non-invasive, sensitive and reproducible technique for identifying and quantifying atherosclerotic burden and CVD risk.

CIMT is a well-validated research tool that has been translated increasingly into clinical practice.

  1. The United States Centers for Medicare and Medicaid has established a Current Procedural Terminology code (0126T) for “Common CIMT study for evaluation of atherosclerotic burden or coronary heart disease risk factor assessment.”
  2. In 2000, the American Heart Association Prevention Conference V concluded that CIMT “can now be considered for further clarification of coronary heart disease (CHD) risk assessment at the request of a physician,” provided that it is performed by an experienced laboratory.
  3. In 2001, the National Cholesterol Education Program (NCEP) Adult Treatment Panel III stated that CIMT “could be used as an adjunct in CHD risk assessment . . . the finding of an elevated CIMT (e.g. 75th percentile for age and sex) could elevate a person with multiple risk factors to a higher risk category. This expert panel concluded that “if carried out under proper conditions, CIMT could be used to identify persons at higher risk than that revealed by the major risk factors alone.””

CT Cerebral Angiogram

In CT angiography (CTA), computed tomography using a contrast material produces a contrast material to produce pictures of blood vessels of the brain.

Physicians use the procedure to:

  • Show the presence of diseased cerebral arteries such as cerebral aneurysms
  • Guide surgeons making in treating repairs to diseased blood vessels
  • Plan for a surgical operation
  • Screen individuals with neurological symptoms for cerebral arterial disease.

You should wear comfortable, loose-fitting clothing to your exam. You may be given a gown to wear during the procedure.

Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and should be left at home or removed prior to your exam.

You may also be asked to remove hearing aids and removable dental work. You may be asked not to eat or drink anything for several hours beforehand, especially if a contrast material will be used in your exam. You should inform your physician of any medications you are taking and if you have any allergies, especially to contrast materials.

Also inform your doctor of any recent illnesses or other medical conditions, and if you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect.

Women should always inform their physician or technologist if there is any possibility that they are pregnant.

MRI Brain

MRI is a non-invasive medical imaging test that uses a magnetic field and radio waves frequency to produce detailed pictures of organs, soft tissues, bone and other internal body structures.

MRI brain produces detail images of the brain & the brain stem. MRI does not use ionizing radiation (as used in x-rays and CT scans).

MRI images allow better evaluation of certain parts of the body that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or CT scan.

  • You will be asked to wear a gown during the examination.
  • Jewelry, metal accessories, dentures and electronic objects should be removed prior to the MRI scan because they interfere with the magnetic field of the MRI machine whilewatches, credit cards and hearing aids can be damaged.
  • An MRI examination is safe for patients with metal implants, but generally excluded for those with implanteddefibrillator or pacemaker, cochlear (ear) implant, brain aneurysms clips, or metal coils placed within blood vessels.
  • Our physician will pre-consult and take your history to ensure your suitability for an MRI examination. Please kindly consult with the physician any doubt that you have.
  • Some MRI examinations may require you to receive an injection of contrast material. The contrast material commonly used for an MRI examination does not contain iodine and is less likely to cause allergic reaction. When the contrast material is injected, it is normal to feel a flushing sensation for a minute or two. Some customers may have a metallic taste in their mouth after the contrast injection

 

The radiographer begins by positioning you on the MRI examination table. Straps and pillows may be used to help you maintain the correct position and to hold still during the examination.

After positioning you, the radiographer will offer you earplugs to reduce the noise of the MRI scanner, which produces loud thumping and humming noises during imaging. These noises are harmless. Then, the radiographer will enter a separate room where the radiographer operates the MRI machine and monitor your examination. The radiographer will be able to see, hear and speak with you at all times.

The table will move slowly through the machine as the MRI scan is performed. When images are being recorded, you will hear a thumping and humming sound. Please remain still while the images are being recorded. It is normal for the area of your body being imaged to feel slightly warm. If it bothers you, please notify the radiographer.

When the examination is completed, you will be asked to wait until the radiologist verifies that the images are of good quality for accurate interpretation. Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes.

Women should always inform their physician or radiographer if there is any possibility that they are pregnant. MRI has been used for scanning patients since the 1980s with no reports of any ill effects on pregnant women or their babies. However, because the baby will be in a strong magnetic field, pregnant women should not have this examination unless the potential benefit from the MRI exam is assumed to outweigh the potential risks.

If you have a hard time staying still, are claustrophobic or have chronic pain, you may find an MRI examination to be stressful. The radiographer, under the direction of a physician, may offer you some sedation prior to the scheduled examination to help you tolerate the MRI scan procedure.

 

MRI Carotids Angiography

Magnetic resonance angiography (MRA) is a non-invasive medical imaging test that uses a magnetic field and radio waves frequency to produce detailed images of the major arteries within the body, such as : brain, heart & other body parts. MR angiography does not use ionizing radiation (x-rays). MRA may be performed with or without contrast material.

You will be asked to wear a gown during the examination.

Jewelry, metal accessories, dentures and electronic objects should be removed prior to the MRI scan because they interfere with the magnetic field of the MRI machine whilewatches, credit cards and hearing aids can be damaged.

An MRI examination is safe for patients with metal implants, but generally excluded for those with implanteddefibrillator or pacemaker, cochlear (ear) implant, brain aneurysms clips, or metal coils placed within blood vessels.

Our physician will pre-consult and take your history to ensure your suitability for an MRI examination. Please kindly consult with the physician any doubt that you have.

Some MRI examinations may require you to receive an injection of contrast material. The contrast material commonly used for an MRI examination does not contain iodine and is less likely to cause allergic reaction. When the contrast material is injected, it is normal to feel a flushing sensation for a minute or two. Some customers may have a metallic taste in their mouth after the contrast injection

The radiographer begins by positioning you on the MRI examination table. Straps and pillows may be used to help you maintain the correct position and to hold still during the examination.

After positioning you, the radiographer will offer you earplugs to reduce the noise of the MRI scanner, which produces loud thumping and humming noises during imaging. These noises are harmless. Then, the radiographer will enter a separate room where the radiographer operates the MRI machine and monitor your examination. The radiographer will be able to see, hear and speak with you at all times.

The table will move slowly through the machine as the MRI scan is performed. When images are being recorded, you will hear a thumping and humming sound. Please remain still while the images are being recorded. It is normal for the area of your body being imaged to feel slightly warm. If it bothers you, please notify the radiographer.

When the examination is completed, you will be asked to wait until the radiologist verifies that the images are of good quality for accurate interpretation. Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes.

Women should inform their physician or radiographer if there is any possibility that they are pregnant.

MRI Cerebral Angiography

Magnetic resonance angiography (MRA) is a non-invasive medical imaging test that uses a magnetic field and radio waves frequency to produce detailed images of the major arteries within the body, such as : brain, heart & other body parts. MR angiography does not use ionizing radiation (x-rays). MRA may be performed with or without contrast material.

 

You will be asked to wear a gown during the examination.

Jewelry, metal accessories, dentures and electronic objects should be removed prior to the MRI scan because they interfere with the magnetic field of the MRI machine whilewatches, credit cards and hearing aids can be damaged.

An MRI examination is safe for patients with metal implants, but generally excluded for those with implanteddefibrillator or pacemaker, cochlear (ear) implant, brain aneurysms clips, or metal coils placed within blood vessels.

Our physician will pre-consult and take your history to ensure your suitability for an MRI examination. Please kindly consult with the physician any doubt that you have.

Some MRI examinations may require you to receive an injection of contrast material. The contrast material commonly used for an MRI examination does not contain iodine and is less likely to cause allergic reaction. When the contrast material is injected, it is normal to feel a flushing sensation for a minute or two. Some customers may have a metallic taste in their mouth after the contrast injection

The radiographer begins by positioning you on the MRI examination table. Straps and pillows may be used to help you maintain the correct position and to hold still during the examination.

After positioning you, the radiographer will offer you earplugs to reduce the noise of the MRI scanner, which produces loud thumping and humming noises during imaging. These noises are harmless. Then, the radiographer will enter a separate room where the radiographer operates the MRI machine and monitor your examination. The radiographer will be able to see, hear and speak with you at all times.

The table will move slowly through the machine as the MRI scan is performed. When images are being recorded, you will hear a thumping and humming sound. Please remain still while the images are being recorded. It is normal for the area of your body being imaged to feel slightly warm. If it bothers you, please notify the radiographer.

When the examination is completed, you will be asked to wait until the radiologist verifies that the images are of good quality for accurate interpretation. Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes.

Women should inform their physician or radiographer if there is any possibility that they are pregnant.

Disclaimer: All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.