Head/ Brain injury imaging Flashcards
Imaging for stroke ?
CT
imaging for malformation and inborn disease ?
MRI
if CI, then use CT
Imaging for Brain trauma?
CT
MRI as 2nd line
Imaging for cerebrovascular disease?
CT+angio/MRI+angio
Angiography for the intervention part
In brain trauma what imaging is particulary important for hemmorhage?
MRI
Imaging for neurodegenerative diseases?
MRI
and/or PET/SPECT
Imaging for infectious/inflammatory disease in the brain?
MRI
Imaging for tumors in the brain?
MRI+contrast and/or functional imaging
what is the main technique for morphological and functional imaging of the brain?
MRI
How does malignant brain tumors appear on MRI?
Intense, non-homogenous impregnation
What is an Arteriography?
An imaging test that uses x-rays and a special dye to see inside the arteries.
what is Digital subtraction angiography?
A fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment.
What is a fluoroscope?
an instrument with a fluorescent screen used for viewing X-ray images without taking and developing X-ray photographs.
What is the indication of Digital subtraction angiography?
treat brain aneurysm, arterio-venous malformation and occlusion/stenosis.
what is the use of US in head imaging?
Very useful for newborn brain
Hypodense lesion on brain CT indicates?
Ischemia
Hyperdense lesion on brain CT indicates?
Hemorrhage
What is the advantage of CTA over DSA?
*Digital subtraction angiography
CTA carries less of a risk for developing neurological complications compared with DSA because of the minimally invasive nature of the procedure.
What contrast do we use in brain CT?
Iodine
How does brain atrophy appear on CT?
Dilation of ventricles and subarachanoid space
what is the origin of the word Tomography?
Tomos - cut
In what color does CSF appear on MRI T-2 weighted?
White
water is white
https://www.youtube.com/watch?v=ka-HBXP5ERA
Looking at MRI you see:
CSF appears black it can be
FLAIR or T-1 weighted
Looking at brain MRI, looking at the sulcus, outside is grey, and inside is white, what is the weighting?
T1
“like normal brain”
Best way to do MRI for anatomic details of the head?
T1 weighted with contrast
What is the contrast agent used when we do MRI T1 weighted with contrast?
Gadolinium
What is the relevancy of T2-weighted MRI imaging in the head?
CNS pathologies, since they tend to accumulate water
T2 it’s an image of the water content
Why do we use MRI or CT in dementias?
To exclude secondary forms (hematomas/neoplasms)
What do we see in primary forms of dementia on CT/MRI?
Signs of atrophy (dilation of ventricles)
Why do we use PET/SPECT for dementias?
To differentiate different forms of dementia
Alzheimer- reduced function of parietal frontal cortex
what do we see on CT when lookin for parkinson?
usually it’s negative
How does Parkinson’s disease appear on MRI?
Atrophy of the compact part of the substantia nigra
What are some uses of FLAIR in brain imaging?
To detect atrophy, white matter plaques, and demyelination.
Imaging used in acute phase (Trauma) of injury and later it’s monitoring?
MRI and CT
When is it beneficial for to use Multi detector CT?
Very useful in Polytraumatic patient
What is the appearance of post-traumatic hemorrhage lesions on CT, in respect to normal tissue?
Hyperdense
What is the appearance of post-traumatic edema lesions on CT, in respect to normal tissue?
Hypodense
After three days since the head trauma, what is the imaging of choice?
CT
especially for the hemorrgic component
Carotid-cavernous fistulas (CCF) can form in skull base fractures. In these cases, the 1st level investigation is?
ANGIO-CT
Angio-CT is done with contrast?
yes
do we use contrast agent in Angio-MR?
No!!!
Imaging for movement disorders?
MRI
Among the most frequent is certainly Parkinson’s disease (caused by a dysfunction of the nigrostriatal dopaminergic system
In parkinson’s disease, CT is usually negative or positive?
Negative
Unless there is associated cerebrovascular disease
How do we see Parkinson’s disease on MRI?
Show signs of atrophy
and thinning/disappearance of PARS COMPATTA of SUBSTANTIA NIGRA.
What can be the use of PET/SPECT in movement disorders?
with dopaminergic tracers can show reduced dopaminergic function of the putamen and caudate basal nuclei.
What is the imaging indicated in cognitive deterioration, Dementia?
CT or MRI
What can allow us an early diagnosis of Alzheimer’s disease?
Atrophy of the unco-hippocampal region can be highlighted with MRI
The measurement of the volume of this region with segmentation techniques seems to be able to allow an early diagnosis of the disease
What is the use of PET and SPECT in different types of dementias?
Used as 2nd level techniques to highlight functional alterations that allow differentiating different forms of dementia
What functional deficits we see in Alzheimer’s disease?
Temporo-parietal association cortex that extend over time to the frontal one
With sparing of the primary sensorimotor cortex, the basal nuclei and the cerebellum.
what deficits we see in frontotemporal dementias?
Frontotemporal lobe functional deficits
What part of the brain in dementia with Lewy bodies is reduced?
Occipital activity
on PET/SPECT what area of the brain it’s activity is impaired in Huntington’s chorea?
Heads of the caudate nuclei
