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CEREBELLO-PONTINE ANGLE (CPA) MRI PROTOCOL

CEREBELLO-PONTINE ANGLE (CPA) PROTOCOL

Intended to provide a detailed examination of the seventh and eight cranial nerves and the other C-P angle structures, especially for detecting acoustic neuromas. The fifth cranial nerve is included on imaging. General brain images are obtained to make the exam more comprehensive.


Typical Indications

  • ? acoustic neuroma
  • ? CP angle lesion
  • SN deafness
  • Vertigo or Tinnitus

Sequences stored under Head/ CP_ANGLE


SCOUT Three plane low resolution scout


PD + T2 AXIAL Full brain coverage TSE axials. 5 mm thick with 50% gap


 

  • Position slices parallel to the line joining the Genu and Splenium of the Corpus Callosum.
  • Cover the brain from below the Foramen Magnum to the Vertex.
  • Sat band just below inferior slice and parallel to the slice

 


CISS_Axial High resolution 3D bright fluid sequence to define the cochlea and semi-circular canals and outline the cranial nerves.


 

  • Centre on the Acoustic nerves, angle to place scan plane roughly parallel to the roof of the 4th ventricle.
  • Use MPR software to correct positional errors and display full length of the nerves. 

 

Variations & Optional Sequences

  • If the CISS images show an acoustic neuroma, or look suspicious do the isotropic MP-RAGE and make axial MPRs.
  • For follow up of known acoustics, and lesions treated with radiosurgery just do post contrast isotropic MP-RAGE with axial and coronal reconstructions.
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