Understanding Your Imaging and Diagnostic Studies

A variety of imaging studies and diagnostic tests are offered when evaluating brain, spine, or nerve related conditions. We use these imaging studies to be able to provide the most accurate diagnosis and personalized treatment plan.

Spine X-Rays (Cervical, Thoracic, Lumbar)

Cervical, Thoracic, and Lumbar Spine X-Ray imaging studies involve a basic imaging examination that uses a small dose of radiation to observe the bones of the neck(cervical), mid-back(thoracic), or the lower back(lumbar). These Spine X-ray studies would be able to confirm more information pertaining to spinal alignment, degenerative disc changes, bone fractures, and to check on any surgical hardware placement from surgery. The Spine X-rays do have limitations in presenting clear imaging of nerves, spinal cord, disc herniations, but the imaging studies would be relatively quick, simple, and painless. They would be performed while standing or lying down depending on what information needs to be obtained and recorded.

Flexion/Extension X-Rays

A special spinal X-rays, the Flexion and Extension X-Rays, are obtained while having the patient bend forward and backward. These Flexion and Extension X-Rays would be able to show any spinal instability, ligament laxity, and/or spondylolisthesis or abnormal movement between vertebrae. During the imaging study, patients will be asked to carefully bend the neck or back forward and backward. It is common for trauma patients, degenerative disc disease patients, or patients with prior surgery to be recommended for these special X-ray imaging studies.

Scoliosis X-Ray

A Scoliosis X-Ray study is a full-spine standing X-ray that measures any present sideways curvature of the spine. Specifically, it presents information about the curve severity, present pelvic tilt, and overall spinal deformity progression over time. This will have the patient only standing during the imaging procedure and will be obtained with both a front and side viewpoint.

CT Scan (Computed Tomography)

A CT Scan provides a fast, detailed imaging study that uses X-rays to create 3D images of the patient’s brain or spine. The CT Scan would be able to provide information on the patient’s condition of bleeding and resulting calcification, skull or spine fracture, and/or hydrocephalus. Usually, a CT Scan is the primary imaging study that is obtained in emergencies, trauma or patients that are presenting sudden neurologic symptoms. The overall imaging procedure takes 5-10 minutes and it would have the patient lie flat on the table that would move the patient through a scanner.

CTA (CT Angiography)

A CT Angiography imaging study is a special type of a CT scan that is performed with contrast dye in order to view the patient’s blood vessels. The CTA imaging study would be able to identify any aneurysms, artery blockages, or AVMs that are present in the patient at the current time of imaging. This imaging procedure would involve a contrast dye that is provided through an IV and overall time it would take would be 15 minutes.

MRI (Magnetic Resonance Imaging)

A MRI imaging study is a powerful test that uses magnetic fields and radio waves to be able to create detailed images of the brain, spine, and nerves. The MRI imaging study provides information on tumors, herniated discs, inflammation, and brain edema. This imaging procedure is much more intensive and would take 30-60 minutes to complete. The patient would be required to lie flat inside of a scanner but there would be no radiation involved.

MRA (Magnetic Resonance Angiography)

An MRA is a specific type of an MRI imaging sequence that focuses on recording flow and functionality of the arteries in the brain and neck. The MRA would also contribute in providing information about aneurysms, vessel narrowing, or AVMs. This procedure is often performed alongside a Brain MRI for patients.

MRI Vessel Wall Imaging (VWI)

An MRI with Vessel Wall Imaging is a specific type of high-resolution MRI study that images and records the walls of arteries, not just the blood flow inside them. An MRI with Vessel Wall Imaging would be able to show the patient’s condition involving vasculitis, aneurysm wall characteristics, intracranial dissections, or vessel plaque. This imaging procedure does take longer than a typical MRI, including IV contrast, and usually is recommended in patient cases of stroke or a complex aneurysm.

MR Spectroscopy

An MR Spectroscopy is an MRI-based test that evaluates the chemical composition of brain tissue. The spectroscopy imaging helps distinguish between tumor, abscess, or radiation injury. Additionally it will help with assessing tumor grade and will provide information that is useful in seizure workups. An MR Spectroscopy will usually be added to a regular standard MRI with no additional prep or discomfort for the patient.

Diagnostic Cerebral Angiogram

A Diagnostic Cerebral Angiogram is a minimally invasive catheter-based test that gives the most detailed view of the brain’s blood vessels. The DSA is the most accurate method to obtain specific information about aneurysm characteristics, AVMs, vessel narrowing, and dissections or fistulas. Dr. Yim usually performs this through radial access while the patient is awake but sedated. With this procedure, contrast dye will be used and the actual imaging procedure will take about 15-20 minutes and the recovery tends to last for 1 hour after the procedure.

Carotid Ultrasound

A carotid ultrasound is a noninvasive imaging ultrasound of the carotid arteries in the neck. This imaging procedure would be able to present information pertaining to plaque buildup, artery narrowing, and stroke risk. The carotid ultrasound is a 15-30 minute examination that is performed with a probe on the patient’s neck.

EMG (Electromyography) and Nerve Conduction Studies (NCS)

EMG and Nerve Conduction Tests are imaging studies that evaluate nerve and muscle function by measuring how electrical signals travel through your body. The actual imaging results would provide information pertaining to any nerve root compression, carpal tunnel, peripheral neuropathy, and/or ALS. The patient should expect to have electrodes placed on their skin and smaller needles inserted into their muscles. There will be some reported discomfort but no sedation will be necessary. The overall procedure will take 30-60 minutes.

Before your consultation, Dr. Yim and his staff will always address any questions you may have and explain which tests are advised for your condition. Utilizing the most cutting-edge, precise, and patient-focused diagnostic instruments to direct your treatment is our top goal.