Imaging the Brain Flashcards
T1 pulse sequence
good for anatomic detail
fluid: black
poor distinction between gray and white matter
T1 + C pulse sequence
highlights vascular structures
ID disruptions in BBB
contrast enhancing: bright (abnormal)
non-contrast enhancing: dark
T2 pulse sequence
identifying fluid
fluid: bright
FLAIR pulse sequence
determining fluid type
normal (CSF): dark
abnormal: bright
T2* pulse sequence
identifying hemorrhage
blood: dark
when to use CT over MRI
cranial and extra cranial structures
skull, nasal cavity, oral cavity, musculature
when to use MRI over CT
intercranial structures
brain, brainstem, nerves, etc
causes of edema in the brain
- cell damage –> damaged proton pumps –> water enters cells –> cells swell
- BBB damage –> water enters –> tissue swells
types of CNS edema
- cytotoxic
- hydrostatic
- vasogenic
cytotoxic edema
intracellular edema from Na/K pump dysfunction
characteristics:
- GM and WM
- cell swells from ischemia
hydrostatic edema
extracellular edema from pressure
characteristics:
- surrounds ventricles
- causes obstructive hydrocephalus
vasogenic edema
extracellular edema from disruption of BBB
characteristics:
- WM
- high protein edema leaks through loose tight junctions
signs of mass/mass effect
- mass (asymmetric)
- midline shift
- edema
- thinning of sulci/gyri
- ventricular obstruction
- herniation
causes of intraventricular hydrocephalus
- obstruction of CSF flow
- overproduction of CSF
herniation
increased pressure in the cranial cavity causes the brain parenchyma to displace:
1. transtentorial
2. subfalcine
3. foraminal