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Home Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
SAH on CT, acute, next imaging study 3194666
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cerebral vasospasm suspected, initial imaging 3194668
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cerebral aneurysm, untreated, surveillance 3194670
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cerebral aneurysm, treated, surveillance 3194672
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cerebral aneurysm screening, high risk 3194674
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
AVF, surveillance 3194676
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
AVM, surveillance 3194677
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
CNS vasculitis suspected, initial imaging 3194679
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US duplex Doppler carotid artery
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US duplex Doppler transcranial
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head perfusion with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head perfusion with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
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