Imaging the Brain Flashcards

1
Q

T1 pulse sequence

A

good for anatomic detail

fluid: black
poor distinction between gray and white matter

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2
Q

T1 + C pulse sequence

A

highlights vascular structures
ID disruptions in BBB

contrast enhancing: bright (abnormal)
non-contrast enhancing: dark

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3
Q

T2 pulse sequence

A

identifying fluid

fluid: bright

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4
Q

FLAIR pulse sequence

A

determining fluid type

normal (CSF): dark
abnormal: bright

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5
Q

T2* pulse sequence

A

identifying hemorrhage

blood: dark

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6
Q

when to use CT over MRI

A

cranial and extra cranial structures

skull, nasal cavity, oral cavity, musculature

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7
Q

when to use MRI over CT

A

intercranial structures

brain, brainstem, nerves, etc

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8
Q

causes of edema in the brain

A
  1. cell damage –> damaged proton pumps –> water enters cells –> cells swell
  2. BBB damage –> water enters –> tissue swells
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9
Q

types of CNS edema

A
  1. cytotoxic
  2. hydrostatic
  3. vasogenic
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10
Q

cytotoxic edema

A

intracellular edema from Na/K pump dysfunction

characteristics:
- GM and WM
- cell swells from ischemia

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11
Q

hydrostatic edema

A

extracellular edema from pressure

characteristics:
- surrounds ventricles
- causes obstructive hydrocephalus

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12
Q

vasogenic edema

A

extracellular edema from disruption of BBB

characteristics:
- WM
- high protein edema leaks through loose tight junctions

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13
Q

signs of mass/mass effect

A
  1. mass (asymmetric)
  2. midline shift
  3. edema
  4. thinning of sulci/gyri
  5. ventricular obstruction
  6. herniation
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14
Q

causes of intraventricular hydrocephalus

A
  1. obstruction of CSF flow
  2. overproduction of CSF
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15
Q

herniation

A

increased pressure in the cranial cavity causes the brain parenchyma to displace:
1. transtentorial
2. subfalcine
3. foraminal

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16
Q

transtentorial/subtentorial herniation

A

cerebrum herniates caudally over the tentorium cerebelli

17
Q

subfalcine herniation

A

one side of cerebrum herniates over the falx cerebri to the other side

18
Q

foraminal herniation

A

cerebellum herniates caudally through the foramen magnum

19
Q

what are the 3 contributors to normal ICP

A
  1. blood
  2. CSF
  3. brain parenchyma
20
Q

what causes an increase in ICP

A

masses
edema/inflammation
obstruction/overproduction of CSF
hemorrhage

21
Q

major categories of CNS disease

A
  1. vascular
  2. metabolic/toxic
  3. inflammatory
  4. neoplastic
22
Q

vascular CNS disease imaging

A

multiple/recurring dark areas on T2* sequence

resolves with time via resorption

23
Q

metabolic/toxic CNS disease imaging

A

bilaterally symmetric lesions

24
Q

categories of inflammatory CNS disease

A
  1. infectious
  2. non-infectious
25
Q

infectious CNS disease imaging

A

T1 + C

peripherally enhancing rim with dark center (pus/necrosis)

if meningitis: contrast enhancing meninges with subdural fluid

26
Q

non-infectious CNS disease imaging

A

GME: white matter
NME: gray matter + subcortical white matter
LE: white matter of brainstem and cerebrum

27
Q

common CNS neoplasia locations

A
  • astrocytic
  • choroid plexus
  • meningeal
  • tumors from cranial/skull base
28
Q

intra-axial neoplasia

A

arises from within brain parenchyma

  • brain surrounds entire mass
    ex. astrocytoma
29
Q

extra-axial neoplasia

A

arises from outside the brain parenchyma

  • has one flat side attaches to skull/meninges
    ex. pituitary tumor, meningioma
30
Q

intraventricular

A

arises from within the ventricles

ex. choroid plexus tumor

31
Q

neoplastic CNS disease imaging

A

brightly contrast enhancing

may have peripheral contrast enhancing rim with dark center