4. Scan Coverage: Floor of sella to thoracic inlet (to scan for nodes) Standard axial scanning at 0 degrees is depicted on the lined scout image in this patient being evaluated for possible tongue tumor. The resulting images, displayed below, all have streak artifact from the patient’s amalgams with a significant portion of the area of interest unable to be evaluated. By following this scan with butterfly images, the area obscured by the streak artifact is well seen.

5. 0 degrees +20 degrees -20 degrees

7. Pathology Case - Floor of Mouth Tumor Invading SLSs T T T T Key: T = Tumor; SLS = Sublingual Space ME = Mandible Erosion U = Ulceration ME U U

9. Normal SMG Abnormal SMG with dilated ducts from stone Oblique reconstruction The submandibuler duct arises from the deep lobe of the gland (medial to mandible) and runs in the sublingual space in the floor of the mouth. The normal duct is not typically seen on CT. This patient has a dilated obstructed submandibuler duct (red arrows) from an anterior floor of the mouth tumor(T). TT

11. This image shows the parotid glands bilaterally. The parotid ducts runs anteriorly and curve medially at the anterior margin of the masseter muscles coursing through the buccal space. They pierce the buccinator muscles and empty into the mouth at the level of the 2ndmaxillary molar. The duct on the left is dilated(from a distal stone) which permits optimal visualization of the course of the duct. Both the gland and duct must be entirely imaged when looking for sialoliths. Dilated parotid duct with sialocele Normal parotid duct Masseter muscle Parotid glands

13. Common Histories / Key Words: R/O carotid stenosis; R/O carotid or vertebral dissection/occlusion, especially associated with trauma; evaluate vessel relationships to tumors (carotid body, etc…)

14. Common carotid artery Internal carotid artery External carotid artery Superior thyroid artery Facial artery Lingual artery Occipital artery Superficial temporal artery Internal maxillary artery External View of SkullCutaway View of Skull

15. Digital subtraction cerebral angiography shows left common carotid artery stenosis (A). Immediately after stent insertion and balloon dilatation in-stent thrombus (arrow) is seen (B). Thrombus disappears after intravenous tirofiban infusion (C).

16. 2D reconstruction of CT angiography of the neck of Patient 1 showing (A) dilatation of the right common carotid artery within the neck to its origin (short arrows) and marked dilatation of the aortic arch. The Petrous component of both internal carotid arteries can be seen to be dilated (long arrow). (B) A more posterior coronal slice showing the left common carotid artery, entire left internal carotid artery and aortic root dilatation.

17. Rupture of a giant carotid-ophthalmic aneurysm: (A) CT of the head shows a subarachnoid haemorrhage from a giant left carotid artery aneurysm (arrow). (B) Three-dimensional impression from the carotid- ophthalmic aneurysm; the ophthalmic artery arises from the sac (arrows). (C) Photograph from rotational run showing extravasations from contrast into the subarachnoid space.