Imaging of the head and the nek

Question 1

What are the indications for an x-ray

Answer 1

Trauma
Degenerative diseases
post-operative

Question 2

Indications for Fluroscopy/angiography

Answer 2

swallow study
interventional radiology
arthography
cardiac catheterization

Question 3

what is Angiography and its indications

Answer 3

form of fluoroscopy intended to evaluate peripheral vasculature

indications: aneurysm, vascular malformations, fistulae, stenosis, thrombosis, dissection, stenting, thrombolysis

Question 4

Angiography pros and cons

Answer 4

pros;
fast
diagnostic and therapeutic

cons;
invasive
contrast
radiation

Question 5

what is myelography and what is its functions

Answer 5

uses fluoroscopy and intrathecal injection of contrast

indications;
spinal stenosis, nerve root compression, CSF leak

Question 6

pros and cons of myelography

Answer 6

pros:
defines subarachnoid space
identifies spinal block

cons:
invasive
CSF leak, headache
radiation
contrast

Question 7

how is radiodensity measured

Answer 7

measured in Hounsfield units

water = 0 HU

All densities are compared to water

hyperdense = white

hypodense = black

Question 8

how are CTs read

Answer 8

cans are read as if looking at the patient from the feet

Question 9

What is CT used for

Answer 9

skull skull base and vertebrae:
-trauma and bone lesions

ventricles:
-hydrocephalus, masses and mass effect

Intracranial masses, mass effect
-headachers, nausea, vomitting, visual symptoms

hemorrhage, ischemia
-stroke, mental status change, focal neurological defects

calcification
-lesion characterization

Question 10

pros and cons of CT

Answer 10

Pros:
fast
relatively inexpensive
good at detecting large pathology

cons:
less detail than MRI
Radiation exposure
low sensitivity in posterior fossa

Question 11

When do you use contrasts

Answer 11

Neoplasm
infection
Vascular disease
Inflammatory disease
More than 3 hours after onset of symptoms

Question 12

When do you not use contrasts

Answer 12

trauma
hemorrhage
hydrocephalus
dementia
epilepsy
within 3 hours of symptoms

Question 13

How to tell if the BBB is broken using contrast

Answer 13

If using a IV contrast, it should not be able to get into the BBB

if it does then you know the BBB is broken somwhere

Question 14

WHat structures get enhanced with IV contrast

Answer 14

cerebral blood vessels
memninges-dura, arachnoid mater, and pia mater
pineal bland
pituitary gland
choroid plexus

Question 15

what is CT angiography and what is its uses

Answer 15

Rapid IV contrast bolus

scanned during arterial phase
digitally reconstructed into 2D and 3D images

Question 16

Pros and cons of CT angiography

Answer 16

pros:
Non invasive
examine vessels from orgin

cons:
contrast
radiation
lower resolution

Question 17

what is the radiodensity for MRI

Answer 17

Hyperintense = white
hyperintense = black

Question 18

What are the uses of MRI

Answer 18

furthur evaluation of CT findings, tumors, infection, joint imaging

Question 19

What are the pros and cons of MRI

Answer 19

pros:
High level of detail
safe to use in pregnancy
vessel imaging can be obtained without the use of contrast

cons:
time consuming
contraindictions (metal/implantable devices)
expensive
claustrophobia

Question 20

what is the details of T1 weighted MRI

Answer 20

CSF is dark
hypointense

white matter is bright
hyperintense

good for imaging normal anatomy

Question 21

what are the details of T2 weighted MRI

Answer 21

CSF is bright
hyperintense

white matter is dark
hypointense

good for visualizing pathology

Question 22

WHat is special about a T2 flair

Answer 22

removes CSF from T2

enhances fluid with high protein content
-edema and abscesses

FLAIR
- fluid attenuated inversion recovery

Question 23

What is and are the uses of ultrasound

Answer 23

noninvasive imaging technique
transducer emits ultrasound waves into the body
transducer then functions as a reciever that records the energy

uses:
evaluation of carotid arteries, placement of central lines

Question 24

what are the pros and cons of ultrasound

Answer 24

Pros:
non-invasive
cheap
no radiation

cons:
learning curve