CTV CTA Scan order from Dr. Costantino

Good morning,

Had my virtual meeting with Dr. Costantino several weeks ago. He said he needed more data and needed a CTA/CTV; I explained that I thought I had the CTV and that they had those results.
And then I thought he was talking about a CT venogram.

I cannot tell from this order what he’s asking for. (He was seemingly not interested in the nerve symptoms, which I was since I’d been assured (see below) there was no compression… Anyone know if he will take a case if there is not compression?). I’ve had sent questions to Dr. C’s office.

Unfortunately, my MRV, ordered by Dr. Rishi Gupta, Vascular Neurologist (on our list), was not dynamic. I was in a lot of pain when I met with him and he ordered the MRV. Many weeks went by before I could do the scan as I couldn’t lay flat due to nerve symptoms. So while I knew from this forum we needed (one (?) of the tests done dynamically), in my fog I didn’t second guess his order…And of course don’t want either test re-done if at all possible.

The right IJV is quite open and Dr. Gupta said there is no compression. (And on that note, since I already had a CT with contrast, which showed the right IJV open and the left IJV small but compressed by left TP of C1… I don’t know why he needed an MRV to see the same thing unless he was checking the brain….?).

I have questioned Dr. Gupta’s assessment since we did not do it dynamically. I asked would there be problems in specific movements and the one I’m most concerned about is my sleeping position, which is upright, where I know my head leans down as I sleep… which ‘could’ mean my styloids would be poking down and back towards my structures. His comment to that question is ‘that is not really the way the anatomy works’? We are meeting again to go over my outstanding questions.

Thanks always for whatever feedback you can provide,

I’m sorry that it’s all so complicated for you, I hope that you can get some clarity on this…maybe reach out to Claudia Valerio in Dr. Costantino’s office, (914) 517-8056 if you’re unsure as to what’s needed? Hopefully others who’ve seen Dr C can clarify too!


Thank you )). I did reach out so surely will be clarified shortly.
The order did not specify dynamic or positional, so asked for clarification on that as well.


I’m sorry that your consult didn’t go better!

I had a CTA & MRV earlier this year to check the vascular situation in my neck & surprisingly, they did show different things. I don’t know if this is helpful for you, @Leah, but it might explain why he wants a CTA/V. At least the contrast in the CT scans is iodine based so isn’t putting a heavy metal into your system like the MRV does. It does obviously give you radiation though.

TY. I likely confused the issue as I didn’t send him my MRV since I thought I was past that. They have it now and asked if possibly it would provide the data he needs.

So in looking online, seems the definition of CTA/CTV is what I had in May specifically for appointment with Dr. C… (Ct w w/o contrast) (?).

CTA/CTV | NorthShore.

As I understand it, a CTA/V is a CT scan w/ contrast that specifically looks at the vascular system in a particular body area. A CT w/ contrast basically does the same thing w/o the radiologic emphasis on studying the veins but more on the overall situation in the area. Dr. C should be able to see what he needs to from your CTA/V but having your MRV in addition will give him another layer of information.

@Leah I had a CT and CTV earlier this week, courtesy of Dr. Costantino. The V, in my case, stood for venography.

“CTV with contrast of the neck with 3D reconstruction…”


Thank you!