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Home Horner Syndrome
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Horner syndrome, acute onset, recent trauma, with or without localizing neuro signs or symptoms, initial imaging 3199278
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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 and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without 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
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Horner syndrome, acute onset, painful, with or without localizing neuro signs or symptoms, initial imaging 3199279
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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 and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without 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
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Horner syndrome, acute onset, neuro signs or symptoms localizing to brain, no trauma hx, initial imaging 3199281
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Horner syndrome, acute onset, neuro signs or symptoms localizing to cranial nerve, no trauma hx, initial imaging 3199282
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Horner syndrome, acute onset, neuro signs and symptoms localizing to spinal cord, no trauma hx, initial imaging 3199284
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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 and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without 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
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
Horner syndrome, nonacute onset, neuro signs and symptoms localizing to spinal cord, no trauma hx, initial imaging 3199285
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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 and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without 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
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Horner syndrome, nonacute onset, neuro signs and symptoms localizing to brain, initial imaging 3199287
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head and orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
May be appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Horner syndrome, nonacute onset, neuro signs and symptoms localizing to cranial nerve, initial imaging 3199288
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head and orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
May be appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Horner syndrome, nonacute onset, nonlocalizable, NOS, initial imaging 3199290
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical and thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and orbits 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 with IV contrast and MRA head and neck 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 and with IV contrast and MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast and MRA head and neck without 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
MRI head without IV contrast and MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine 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
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without IV contrast and CTA head and neck with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
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