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Radiology and Anatomy > Brain Imaging > Flashcards

Brain Imaging Flashcards

1
Q

What is the first line imagine modality for the brain?

A

CT

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2
Q

What are the features of CT scans as they relate to the brain?

A

Well tolerated and fast
Can be with or without IV contrast
Can be used for specialist investigations = angiography

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3
Q

What are some features of MRI scans as they relate to the brain?

A

Better soft tissue resolution than CT

Longer duration, contra-indicated for some and can be poorly tolerated

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4
Q

What causes ischaemic stroke?

A

Results for sudden cessation of adequate amounts of blood reaching parts of the brain = divided according to territory affected or mechanism

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5
Q

What does ischaemic stroke lead to?

A

Deprivation of glucose and oxygen = if circulation not re-established cell death occurs, usually by liquefactive coagulation

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6
Q

What causes ischaemic stroke?

A

Embolism = cardiac, paradoxical, fat, air, atherosclerotic
Thrombosis = perforator (lacunar infarct), acute plaque rupture with overlying thrombosis
Arterial dissection

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7
Q

What type of MRI is best used for visualising pathology?

A

T2 weighted scan (T1 best for anatomy)

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8
Q

Why do we image acute ischaemic stroke?

A

To exclude intracranial haemorrhage and stroke mimics
To confirm ischaemia
To permit rapid treatment

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9
Q

How are ischaemic strokes imaged?

A

Using non-contrast CT

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10
Q

What is the earliest CT signs of an ischaemic stroke?

A

Hyperdense segment of vessel = direct visualisation of clot

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11
Q

What are some signs of an ischaemic stroke that can be seen on CT within the first few hours?

A

Loss of grey/white matter differentiation
Hypoattenuation of deep nuclei
Cortical hypodensity with associated parenchymal swelling with resultant gyral effacement

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12
Q

What causes significant mass effect on CT in ischaemic stroke?

A

Marked hypoattenuation and swelling

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13
Q

How long does it take for gliosis to be visible on a CT of an ischaemic stroke?

A

After 24-48hrs = appears as region of low density and volume loss

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14
Q

How does acute blood appear on an unenhanced CT?

A

Appears white

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15
Q

What are some features of intra-axial haemorrhages?

A

may be due to acute haematoma = can cause lobar haemorrhage

Can cause midline shift of ventricles

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16
Q

What is an extra-dural haemorrhage?

A

Collection of blood between inner skull and outer layer of dura = usually associated with skull fracture

17
Q

What kind of bleed occurs in extra-dural haemorrhages?

A

Normally arterial = most commonly torn middle meningeal artery

18
Q

What are some features of extra-dural haemorrhages?

A

Biconvex in shape = can cause mass effect with herniation

Limited by cranial sutures

19
Q

What is a subdural haemorrhage?

A

Collection of blood in subdural space = mainly due to head trauma

20
Q

What is the first choice imaging technique for subdural haemorrhages?

A

CT scan

21
Q

What are some features of subdural haemorrhages?

A

Semilunar shape and crosses sutures
Has mass effect if large
Subacute appears isodense and chronic appears hypodense

22
Q

What is a subarachnoid haemorrhage?

A

Blood in the subarachnoid space = hypodense material seen in space

23
Q

Where do subarachnoid haemorrhages commonly occur?

A

Around the circle of Willis

24
Q

What are some causes of subarachnoid haemorrhages?

A

85% associated with berry aneurysms

May be related to trauma or other vascular malformations

25
Q

What are some features of subarachnoid haemorrhages?

A

Can have larger volume of high attenuation acute blood in sulci, sylvian fissures and supracellar cistern

26
Q

What is CT angiography used for in subarachnoid haemorrhages?

A

To look for berry aneurysms

27
Q

What are some complications of a subarachnoid haemorrhage?

A

Hydrocephalus, vasospasm, infarction

28
Q

What kind of group of tumour are intracranial tumours?

A

Heterogenous group of tumours

29
Q

What are the majority of intracranial tumours in adults?

A

Metastases = from lung, breast, renal cell or colorectal cancer, or melanoma

30
Q

What is the first line investigation for intracranial masses?

A

CT = hypo/hyperdense, often rounded

CT useful for determining oedema or mass effect

31
Q

Why may contrast be used when imaging intracranial masses?

A

May make lesions more conspicuous

32
Q

What are some features of metastases?

A

Usually multiple = supra/infratentorial
Lots of oedema and mass effect
Avidly enhance

33
Q

What does the grade of a primary tumour influence?

A

The degree of oedema, mass effect and enhancement seen

Radiology and Anatomy (4 decks)

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