Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fall 2014 Neuro Ophthalmic Disease > Fall 2014: Lecture 2: Neuroradiology Lecture > Flashcards

Fall 2014: Lecture 2: Neuroradiology Lecture Flashcards

1
Q

Plain Film X-Ray

  1. Projection
    a. Antero-Posterior (AP)
    b. Posterior-Anterior (PA)
    c. Lateral
    d. Waters/Occipitomental
  2. Is Pt exposed to Radiation?
  3. Radiodensities from Least Dense to Densest?
  4. What organ will be visualized best?
  5. Ophthalmic Indications? (3)
  6. TEAR DROP SIGN is noted with what?
A
  1. a. Back of Skull
    b. Front of Skull, Sinuses
    c. Side Profile
    d. Orbits, Frontal and Maxillary Sinuses
  2. YES
  3. Air (Black) –> METAL (Brightest)
  4. The one closest to the X-Ray Film
  5. IOFB, Facial Trauma, Skull Fractures
  6. Orbital Blow-Out Fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Computed Tomography (CT)

  1. Most Efficient Screener for what 4 things?
  2. Pt exposed to Radiation?
  3. Types of Images taken? (3)
  4. The Beams produce images that are how thick?
  5. How does it create the image?
    a. Value used?
    b. Unit Range?
    c. + 1000 = ?
    d. -1000 = ?
  6. Weight Limit?
  7. 0 HU?
  8. -30 to -100 HU?
A
  1. Acute Hemorrhage, Bone, Calcium, and Acute Head Trauma
  2. YES
  3. Axial, Coronal, Sagittal
  4. are 1-10 mm thick.
  5. Multiple x-ray projections are used to reconstruct tissue structures (uses an algorithm)
    a. Hounsfield Units (HU).
    b. 2000 unit range
    c. Bone Attenuation (BRIGHT WHITE)
    d. AIR (BLACK)
  6. 450 lbs!
  7. CSF!
  8. FAT
    * Bone/Metal –> Calcification –> Acute Blood –> Gray Matter –> White Matter –> CSF –> Fat –> Air
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CT (2)

  1. What can be used to improve VISIBILITY of the vasculature and Detect areas of ABNORMAL BBB?
    a. Contrast Dye should be AVOIDED in what Pts?
    b. What BLOOD TESTS should be done before doing this test?
  2. What kind of slices should be ordered when ordering ORBIT STUDIES?
  3. What is BONE WINDOWING and when should it be ordered?
A
  1. Iodine-Based Contrast Dye
    a. Pts ALLERGIC to IODINE, Shellfish, and Abnormal Kidney Function
    b. BUN and Creatinine (Determines how well the Kidneys are functioning)
  2. 1-2 mm slices cuz u MAY miss SMALL LESIONS w/the routine 3-5 mm slices.
  3. Allows optimal evaluation of TISSUES by suppressing bright white bone signal and intraconal fat.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CT (3)

  1. Other CIs (10)
A
  1. Aminoglycoside Exposure
  2. Anuria
  3. Cardiovascular Insufficiency (CI)
  4. Diabetes (Glucophage)
  5. Hepatorenal Syndrome
  6. Hyperthyroidism
  7. Hypertonus
  8. Hyperuricemia
  9. Multiple Myeloma/Paraproteinemias
  10. Plasmacytoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MRI

  1. How does it work?
    a. Named after whom?
    b. Scanner strength range?
    c. Most readily available scanner?
    d. 3T Scanners?
  2. Radiation?
  3. Best used?
    a. PRIMARY CHOICE IN WHAT?
  4. 2 Types of Pulse Images?
A
  1. Magnetic Field aligns Hydrogen Atoms in Tissue
    a. Nikola Tesla (T)
    b. T = Measure of Magnetic Field Strength (0.3T - 3.T w/3T being strongest)
    c. 1.5T Scanner
    d. Commercially available and have the highest level of resolution
  2. NONE
  3. SOFT TISSUE
    a. in Majority of NEURO-OPHTHALMIC DISORDERS
  4. T1-Weighted Image (T1WI) and (T2WI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MRI (2)

  1. T1WI are sometimes used with what Contrast Dye?
  2. Weight Limit?
  3. T1 vs. T2 Images are based off of RELAXATION TIMES.
    a. What comes out as WHITE?
    b. What comes out as BLACK?
  4. T1: Black –> White?
  5. T2: Black –> White?
A
  1. Contrast Dye Gadolinium.
  2. About 350 lbs.
  3. T1: HIGHER msec (180-2000 msec) and T2: Lower msec (90-300 msec)

a. CSF
b. Fat

  • CSF > Gray Matter > White Matter > Muscle > Fat (msecs)
    4. CSF –> Fat
    5. Fat –> CSF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MRI (3)

  1. What’s a FAT Suppression Technique called?
    a. What does it do?
    b. When should it be done?
A
  1. STIR (Short T1 Inversion Recovery)
    a. Transforms bright signal of Fat into a BLACK signal. Gives u BETTER ORBITAL IMAGING before and after contrast administration.

b. For all orbital studies. Best completed in a CLOSED GANTRY vs an Open Gantry MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MRI (4)

  1. What does FLAIR refer to?
    a. What does it do?
    b. Purpose?
A
  1. Fluid Attenuated Inversion Recovery
    a. Transforms bright CSF signal to a BLACK Signal while maintaining other characteristics of a T2WI

b. Best to Detect PERIVENTRICULAR WHITE MATTER LESIONS in DEMYELINATING Processes (MS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MRI (5)

  1. Diffusion Weighted Imaging (DWI)
    a. Use?
    b. Ideal for identifying what?
    c. Signal is abnormal when?
    d. What may be normal in an ACUTE INFARCT?

e. Old Ischemic Lesions DO NOT SHOW What?
f. This also helps differentiate what?

A
  1. a. Detect Recent Vascular Perfusion Alterations
    b. Recent Ischemic Episodes (like STROKE)

c. W/in MINUTES of INFARCTION, and persists for 3 wks.
d. CT and MRI.
e. Don’t show restricted Diffusion.
f. CYSTIC TUMORS and Abscesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MRI (6)

  1. Apparent Diffusion Coefficient (ADC Map) is an alternative view of what?
    a. Lesions that appear black in the ADC Map will look how in DWI?
A
  1. An alternative view of DWI.

a. They will look WHITE!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MRI (7)

  1. ABSOLUTE CIs? (6)
A
  1. Metallic Implants/FB
  2. Electronic, Magnetic, and Mechanically activated implants
  3. Cardiac Defibrillators
  4. Cardiac Pacemakers
  5. CNS Ferromagnetic Hemostatic Clips
  6. Neurostimulators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MRI (8)

  1. Relative CIs for MRI (10)
A
  1. Cardiac Stents
  2. Cochlear Implants
  3. Hemostatic Clips (Body)
  4. Insulin Pumps
  5. Lead wires or similar wires
  6. Nerve Stimulators
  7. Non-Ferromagnetic Stapedial Implants
  8. Other Pacemakers (e.g. Carotid Sinus)
  9. Prosthetic heart valves
  10. Transdermal Patch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MRI (9)

  1. Gadolinium Contrast Dye
    a. What does it do?
    b. It improves what?
    c. Differentiates what?

d. What Blood tests should be done?
2. Pts w/SEVERE RENAL FAILURE, Stages 4 or 5, w/a GFR

A
  1. Improves visibility of Intracranial Vasculature and Detects abnormalities of BBB.
    a. Anatomical Detail
    b. Signal enhancement of normal and pathological tissues

d. BUN and Creatinine clearance.
2. NEPHROGENIC SYSTEMIC FIBROSIS (NSF) (Dermatopathy that leads to FIBROSIS of Skin and Internal Organs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MRI (10)

  1. Contrast Dye CIs for MRI-Associated Gadolinium (6)
A
  1. Abnormal Kidney Function
  2. Gadolinium allergy
  3. Hemodialysis
  4. Hepatorenal Syndrome
  5. NSF
  6. Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Computed Tomography Angiography (CTA)

  1. How is it done?
    a. What does it evaluate?
  2. Most Common Ophthalmic use? (7)
  3. Contrast dye needed?
  4. CTA is complementary to MRA, but which is more preferred and why?
  5. CIs?
A
  1. CT scanner w/3D reconstruction to make images
    a. Intracranial and Extracranial ARTERIES!
  2. a. Arterial and Carotid Stenosis
    b. Aneurysms greater than 3 mm in size
    c. Arteriovenous malformation (AVM)
    d. Carotid Cavernous Fistula (CCF)
    e. Carotid Dissection of the Head/Neck
    f. Vascular Thrombosis
    g. Vascular Tumors
  3. Yes
  4. CTA due to having a slightly better Detection of CEREBRAL ANEURYSM and AVM.
  5. SAME as for CRANIAL CT!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Computed Tomography Venography (CTV)

  1. How is it done?
  2. Helps Dx what? (2)
    a. What is a possible presenting sign of either of these 2?
  3. Contrast dye needed?
  4. Complementary to what?
  5. CIs?
A
  1. CT scanner to look at Intracranial and Extracranial Veins via 3D reconstruction!
  2. Cerebral Venous Sinus Thrombosis (CVST) or Stenosis
    a. Bilateral Optic Disc Edema; It’s frequently included in a PAPILLEDEMA W/U
  3. YES
  4. MRV
  5. Cranial CT scan CIs.
17
Q

Magnetic Resonance Angiography (MRA)

  1. How is it done?
  2. Ophthalmic INDICATIONS?
  3. Contrast Dye?
  4. CIs?
A
  1. Uses a MR scanner (Intra and Extra cranial Arteries…3D reconstruction)
  2. Similar to those of CTA
  3. NO! BUT, it can be used to distinguish flowing blood vs. Stationary Tissue water.
  4. Same as for Cranial MRI
18
Q

Magnetic Resonance Venography (MRV)

  1. Use
  2. Ophthalmic Indications?
  3. Contrast dye?
  4. CIs?
A
  1. MR scanner…3D reconstruction of Cranial Veins
  2. Similar to CTV
  3. NO
  4. Same as Cranial MRI
19
Q

Conventional Catheter Angiography (CCA)

  1. AKA?
  2. GOLD STANDARD for what?
  3. Image Resolution is superior to what?
  4. Problem?
    a. Selective Catheterization of the Cervical and Intracranial Arteries occurs via what?
  5. Dye that is injected?
  6. How is stuff imaged?
  7. Morbidity?
A
  1. Digital Subtraction Angiography (DSA)
  2. for INTRACEREBRAL VASCULAR IMAGING!
  3. CTA and MRA and can DETECT ANEURYSMS LESS than 3 mm in SIZE via 3D Reconstruction.
  4. INVASIVE: Go in via FEMORAL ARTERY CATHETER
    a. Via the AORTA!
  5. Radiodense non-iodinated or iodinated contrast dye.
  6. X-Rays are taken.
  7. 1-5% of patients (Embolism, Vasospasm, TIA, CVA, Aortic or Cervical Artery Dissection, Dye-related RxN, Groin Hematoma, or Femoral Artery Pseudoaneurysm)
20
Q

Vascular Echography (2)

A
  1. Carotid Duplex

2. Transcranial Doppler

21
Q

Carotid Duplex

  1. What is it?
  2. What does it help us understand?
  3. The DUPLEX report uses what kind of image?
  4. The Doppler imaging provides info on what?
  5. Ophthalmic Indications?
A
  1. Ultrasound…to look at CERVICAL CAROTID ARTERIES
  2. BF direction, Velocity, Turbulence, and Vessel Patency
  3. B-Scan image of Vessels
  4. on BF w/in Vessels
  5. Analysis for Carotid Insufficiency in Retinal or Optic Nerve Ischemia!!
22
Q

Transcranial Doppler

  1. What is it?
  2. Study may be indicated in what?
A
  1. Non-invasive. Evaluates VELOCITIES of Intracranial Cerebral Circulation of the Ophthalmic Artery
  2. a. Detection of Vasospasm in Subarachnoid Hemorrhage
    b. Vessel Stenosis
    c. Intracranial Hemodynamic Impairment in Pts w/ Carotid Artery Stenosis and Occlusion1

Fall 2014 Neuro Ophthalmic Disease (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions