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Anatomy BLOCK 3 > Imaging Of The Brain/vasculature > Flashcards

Imaging Of The Brain/vasculature Flashcards

1
Q

25 y/o male presents to the ER with head trauma. Diagnostic test of choice?

A

CT brain without contrast

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2
Q

Which imaging modality of the brain causes no radiation exposure to the patient?

A

MRIq

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3
Q

55 y/o female presents to the ER with unilateral weakness, onset 30 minutes ago. Initial diagnostic test of choice?

A

CT brain without contrast

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4
Q

What are the imaging options for the brain?

A
  • CT

- MRI

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5
Q

CT

A
  • high radiation dose to patient
  • quick examination
  • expensive
  • mainstay and test of choice in the initial imaging of the brain in trauma and stroke like symptoms (WITHOUT CONTRAST)
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6
Q

What is the mainstay and test of choice in the initial imaging of the brain in trauma and stroke like symptoms (without contrast)?

A

CT

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7
Q

What kind of tests would you do a CT without contrast?

A

Trauma, stroke-like symptoms

Used in assessment of altered mental status, headache, dizziness, vertigo, evaluation of the paranasal sinuses

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8
Q

CT brain with contrast

A
  • not performed in initial assessment
  • used in assessment of abnormal enhancement patterns such as masses, vascular abnormality. MRI also used in similar capacity. MRI more sensitive than CT
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9
Q

What is used in assessment of abnormal enhancement patterns such as masses, vascular abnormality such as avascular malformation?

A

CT with contrast

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10
Q

which is more sensitive? MRI or CT?

A

MRI

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11
Q

What parts of the brain anatomy should you see in a CT of a healthy brain?

A
  • midline flax
  • frontal horns of lateral ventricles
  • third ventricle
  • basal cistern
  • skull
  • scalp
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12
Q

What part of the brain would you need to scan if someone complained of vision problems?

A

Occipital

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13
Q

MRI

A
  • no radiation
  • very expensive
  • takes longer than CT therefore motion sensitive
  • DWI: most sensitive sequence in radiology in the assessment of acute ischemia
  • typically done with and without contrast
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14
Q

When do you typically do MRI?

A

After you do a CT and it shows something abnormal

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15
Q

TPA

A
  • very dangerous
  • make sure they aren’t bleeding anywhere
  • extreme blood thinner
  • not goof to look for blood
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16
Q

Which takes longer? MRI or CT?

A

MRI

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17
Q

DWI

A

Most sensitive sequence in radiology in the assessment of acute ischemia

18
Q

Contraindications of MRI

A

-pacemaker, radioplate foreign bodies, claustrophobia

19
Q

Welders and MRI

A

Must do an xRay on eyes to make sure there is no metal pieces lodged in eye before getting into MRI so as to not rip through optic nerve and ophthalmic artery

20
Q

What contrast used in CT?

A

Iodine contrast

21
Q

What contrast used in MRI?

A

MGd

22
Q

What is good for people who are allergic to contrast?

A

MGd. It contains gadilium. Very rare to have allergy with this

23
Q

Imaging options in the assessment of the cerebral vasculature

A
  • CTA
  • MRA
  • ultrasound
  • digital angiography
24
Q

CTA contraindications

A

Allergy, renal insufficiency

25
Q

How do you get around patients having an allergy to iodine when you must do a CTA?

A

Harvard Prep hours before CT

26
Q

How do you get around renal insufficiency when a CTA must be done?

A

Hydrate pt well or dialysis

27
Q

What kind of images can you get with CTA?

A

-axial, coronal, sagittal, reformatted

28
Q

What is the number one place that saccular aneurysms occur?

A

Anterior communicating artery (posterior is second)

29
Q

MRA

A

Good to assess vascular without contrast

30
Q

Contraindications of MRA

A

Same as MRI

31
Q

Time of flight sequences in MRA

A

Allows assessment of the vasculature WITHOUT using contrast

32
Q

Ultrasound

A

Used in the assessment of vascular flow within the vertebral arteries
-shows antegrade vs retrograde flow

33
Q

What direction should bloodflow be?

A

Antegrade

34
Q

When will you see retrograde blood flow in US

A

In subclavian steal syndrome

35
Q

Digital angiography

A
  • High radiation dose

- abnormalities such as aneurysms/AVM can be fixed at time of angiography

36
Q

Contraindications of digital angiography

A

-allergic to contrast, renal insufficiency

37
Q

Complications of digital angiography

A

Vascular trauma, pseudoaneurysm, small risk of death (coils are sharp)

38
Q

Imaging options of the spinal column

A
  • CR
  • CT
  • MRI
39
Q

What is the test of choice in the initial assessment of trauma to the neck/ c-spine, thoracic spine and lumbar spine?

A

CR because of low radiation dose and cheap

40
Q

If CR negative and patietns symptoms persist and/or clinical suspicion high for abnormalities what’s the next test of choice?

A 
Generally CT (especially ER setting)
MRI (if one wants to rule out cauda equine syndrome)
41
Q

Imaging options of the spinal cord

A
  • MRI (best)

- CT myelogram

42
Q

CY myelogram

A

Flip patient upside down, but don’t let it pass the cervical part of spine. Will cause awful headache if it gets in brain

Anatomy BLOCK 3 (13 decks)

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