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SCRN > Imaging > Flashcards

Imaging Flashcards

1
Q

What does DSA stand for?

A

Digital subtraction angiography

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2
Q

What is considered the gold standard for visualizing the arteries in the brain

A

Digital subtraction angiography

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3
Q

What is TTE used for?

A

To see wall motion abnormalities, low left ventricular ejection fraction (<20-30%), valvular abnormalities, and PFO.

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4
Q

What can TEE show?

A

Atria, left atrial appendage clot, size of PFO, PFO associated with atrial septal aneurysm, aortic arch atheroma

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5
Q

Transcranial Doppler US (TCD) with bubble study is used to detect…

A

Right to left shunt

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6
Q

What is TCD used to detect?

A

Monitoring vasospasm in SAH

To detect occlusion, recanalization, and reocclusion of the large intracranial arteries in real time

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7
Q

What does a MRA show?

A

The cerebral arterial anatomy.

Diagnose intracranial and extracranial stenosis, aneurysms, or dissections.

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8
Q

What is CTP (CTperfusion) used for?

A

Shows a better definition of ischemic brain tissue earlier than a non-contrast CT.
Requires more contrast, 2-4 axial slices, more radiation, and patient cooperation.

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9
Q

Why are MRI/MRA done?

A
  • To localize the lesion
  • To understand the mechanism
    + small vessel lacunar infarcts
    + large artery atherosclerosis
    + embolism
    + hemodynamic
    + venous
  • To differentiate between old and new using diffusion weighted sequence
  • To understand tissue physiology (perfusion imaging)
  • To look for stenosis, dissection, aneurysm, AVM
  • Incidental findings
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10
Q

In what situations is a repeat CT helpful?

A

To localize lesion in pts unable to have MRI
Evaluation of the deteriorating pt to assess
- mass effect/edema
- to look for hemorrhagic conversion
- to look for stroke reoccurrence

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11
Q

Why is a CTA head/neck done?

A

To look for arterial stenosis, dissection, aneurysm

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12
Q

Why is a TTE (w/bubble study) done

A 
To assess embolic source
- anterior wall or apical akinesis
- clot
- valvular disease
- large PFO
To detect a low EF (20-30%)
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13
Q

A TEE w/ bubble study can see what that a TTE cannot?

A 
Aortic atheroma
PFO
Atrial septal aneurysm
Spontaneous echo contrast
Left atrial appendage clot
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14
Q

A carotid US is looking for

A

Carotid Artery stenosis or occlusion

Direction of vertebral artery flow

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15
Q

A TCD is used to detect

A
  • Clot presence and lysis in the acute setting
  • Confirmation of intracranial stenosis/occlusion of major arteries seen on MRA or CTA
  • Emboli detection/ monitoring
  • When used with bubble study it is the least expensive/invasive way to screen for R -> L shunting
  • Hemodynamic reserve
  • Evaluate collateral flow patterns
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16
Q

What is DSA used to detect?

A
  • Gold standard for determining degree of stenosis

- Only way to definitively delineate and follow aneurysm or AVMs, dissection, vasculitis, or other arteriopathies

17
Q

What can a CT detect?

A 
Infarction 
Tumors
Hemorrhage - location and extent of SAH, pattern of hemorrhage
Calcification
Bone trauma 
Hydrocephalus 
Midline shift
18
Q

On a CT what do areas of dark and bright represent

A 
Dark = hypodense - indicates infarction and brain edema
Bright= hypersense - indicates calcifications and hemorrhage
19
Q

What do CT perfusion studies measure?

A

Measures cerebral blood flow and ischemic tissue not yet infarcted.

20
Q

What is the purpose of performing a CT perfusion study

A

To select pts for reprofusion therapy past the TPA window by identifying tissue at risk for infarction and

21
Q

Why is a CT Angiogram performed?

A

It is the STANDARD for diagnosing cerebral aneurysms, AVMs, dissections and fistulas

22
Q

What is and why is a CTA performed

A

Noninvasive 3D map of vessel anatomy.

Used to determine the presence of vessel abnormalities such as occlusions, AVM, and aneurysms

23
Q

What does a MRI show

A

Contrast between different soft tissues

Can detect necrotic tissue, oxygen deprived tissue and degenerative diseases.

SCRN (26 decks)

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