Brain Imaging

Question 1

In a T2 weighted MRI scan does water show up bright or dark?

Answer 1

Bright

Question 2

In a T1 weighted MRI scan does water show up bright or dark?

Answer 2

Dark

Question 3

In which MRI scan (T1 or T2) is anatomical resolution better?

Answer 3

T1

Question 4

In which MRI scan (T1 or T2) is pathological tissue highlighted?

Answer 4

T2

Question 5

On a brain MRI you see that the ventricles show up bright white. Is this a T1 or T2 weighted image?

Answer 5

T2

Question 6

Describe how you would get a CT angiogram?

Answer 6

CT image during and immediately after pumping in a bolus of iodine contrast

Question 7

Describe how you would get a CT venogram?

Answer 7

CT image 2.3 seconds after pumping in a bolus of iodine contrast

Question 8

When would you get iodine contrast showing up in the brain? How would you look for this on a CT?

Answer 8

If the blood brain barrier has been disrupted by tumours or inflammation. CT scan taken 5 minutes after iodine contrast injection.

Question 9

What test would you want to do in a young women who has suffered from a confirmed spontaneous subarachnoid haemmorhage?

Answer 9

Angiography

Question 10

What is the gold standard test for imaging blood vessels in the neck and intracranially?

Answer 10

Digital Subtraction angiography

Question 11

What kind of aneurysm involves all layers of the vessel wall and most commonly arises at arterial bifurcation points?

Answer 11

Saccular aneurysms

Question 12

What is the first line imagining to do in someone who has presented with a suspected subarachnoid haemorrhage?

Answer 12

CT scan

Question 13

What is the treatment for a berry aneurysm?

Answer 13

Craniotomy and clipping

Endovascular treatment

Question 14

Describe the endovascular treatment used in brain aneurysms?

Answer 14

Detachable platinum coils are put into the aneurysm to slow the blood flow in and out and allow thrombosis to occur which will eventually seal the aneurysm

Question 15

Describe the angiography procedure

Answer 15

Contrast is injected into the aortic arch and into the carotid or vertebral arteries and X rays are taken.

Question 16

What is the first line imagine technique for a suspected subarachnoid haemmorhage?

Answer 16

Non contrast CT

Question 17

What colour does blood show up on a CT?

Answer 17

Bright

Question 18

Why might you get hydrocephalus with a large volume sub arachnoid haemmorhage?

Answer 18

Blood might spread throughout the basal cisterns and extend into the ventricles. This obstructs CSF drainage and can cause hydrocephaul

Question 19

If you have a confirmed SAH on CT what imaging test would you want to do next?

Answer 19

Cerebral angiogram

Question 20

If there is strong clinical suspicious of a SAH but the CT looks normal what test would you do?

Answer 20

Lumbar pucture to look for elevated red cell count

Question 21

Where is a subdural haematoma?

Answer 21

Between the dura and arachnoid

Question 22

What causes a subdural haemoatoma?

Answer 22

Rupture of the veins that cross this space

Question 23

Who is most at risk of a subdural haematoma?

Answer 23

Those with cerebral atrophu as the subdural space is larger and the veins are at increased risk of injury.

Question 24

Where is an extradural haematoma?

Answer 24

Between the skull and the dura

Question 25

What causes an extradural haematoma?

Answer 25

Traims causing damage to the middle meningeal artery

Question 26

What is the shape of extradural haematoma on CT?

Answer 26

Lens shaped