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TAS Neurology > Imaging the Nervous System > Flashcards

Imaging the Nervous System Flashcards

1
Q

What is the CNS imaging modality of choice in neonates and infants?

A

Cranial ultrasound

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2
Q

Why is cranial ultrasound the imaging modality of choice in neonates and infants?

A

Due to the ease of scanning via the open anterior fontanelle

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3
Q

What are the advantages of cranial ultrasound?

A

Quick and non-invasive

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4
Q

What are the disadvantages of cranial ultrasound?

A

Highly operator dependant

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5
Q

What do repeat cranial ultrasounds over time allow for?

A

Evolution and progression of lessons to be monitored

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6
Q

What is cranial ultrasound particularly used for?

A
  • Intraventricular haemorrhage
  • Ischaemic cysts of periventricular leukomalacia (PVL)
  • Ventricular dilatation
  • Range of cerebral malformations and other lesions, e.g. agenesis of the corpus callosum
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7
Q

What is MRI much better at than cranial ultrasound?

A
  • Detecting ischaemic lesions, e.g. hypoxic-ischaemic encephalopathy or PVL
  • Detailed anatomy of cerebral malformations
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8
Q

What are the advantages of cranial CT?

A
  • Widely available

- Rapid

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9
Q

What is cranial CT used for?

A
  • Head trauma
  • If clinical condition unstable
  • Intracranial calcification
  • Haemorrhage
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10
Q

How can cranial CT images be enhanced?

A

With the use of contrast

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11
Q

Why has cranial CT been largely replaced by MRI?

A
  • Does not require radiation

- Usually more informative

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12
Q

What is MRI imaging the technique of choice?

A

In most paediatric neurological disorders

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13
Q

What is the purpose of different sequences in MRI?

A

Can be used to interrogate the signal to answer particular clinical questions

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14
Q

What are the different sequences in MRI?

A
  • T1
  • T2
  • FLAIR (fluid attenuated inversion recovery)
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15
Q

Describe the appearance of CSF, grey matter, and white matter on T1 MRI sequence?

A
  • CSF appears black
  • Grey matter is grey
  • White matter is white or paler grey
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16
Q

What is T2 sequence used for?

A

Assessing tissue fluid contents, such as oedema

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17
Q

How does CSF appear on T2 MRI sequence?

A

White

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18
Q

What is FLAIR sequence used for?

A

Lesions close to the ventricles

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19
Q

What is the purpose of FLAIR sequence?

A

Signal from CSF is reduced to allow clearer tissue imaging

20
Q

How does a solid mass appear on;

a. T1
b. T2
c. FLAIR?

A

a. T1 - dark
b. T2 - bright
c. FLAIR - bright

21
Q

How does a fluid-filled cyst appear on;

a. T1
b. T2
c. FLAIR?

A

a. T1 - dark
b. T2 - bright
c. FLAIR - dark

22
Q

How does subacute blood appear on;

a. T1
b. T2
c. FLAIR?

A

a. T1 - bright
b. T2 - bright
c. FLAIR - bright

23
Q

How does a acute and chronic blood appear on;

a. T1
b. T2
c. FLAIR?

A

a. T1 - grey
b. T2 - dark
c. FLAIR - dark

24
Q

How does fat appear on;

a. T1
b. T2
c. FLAIR?

A

a. T1 - bright
b. T2 - dark
c. FLAIR - bright

25
Q

What has increased availability of MRI scanning in children allowed for in a wider sense?

A

Expand knowledge about pathological processes occurring in children with encephalopathy

26
Q

What does functional MRI allow for?

A

Visualisation of regional oxygen consumption and blood flow

27
Q

What is functional MRI used to examine?

A

Brain activity

28
Q

What does functional MRI create?

A

A map showing which parts of the brain are involved in a particular task, such as movement or speech

29
Q

Where is functional MRI being increasingly used?

A

In pre-surgical assessment of children being considered for epilepsy surgery

30
Q

What does functional MRI allow in the pre-surgical assessment of children being considered for epilepsy surgery?

A

More accurate prediction of post-op functional outcome

31
Q

Give an example of a disorder that functional MRI has enhanced understanding of?

A

Autism

32
Q

What is MRA?

A

Magnetic resonance angiography

33
Q

What does MRA permit?

A

Non-invasive assessment of the intracranial vascular system

34
Q

Where is MRA of particular use?

A

Conditions such as intracranial arteriovenous malformations, e.g. Sturge-Weber syndrome, and blockages/stenosis

35
Q

What is MRS?

A

Magnetic resonance spectroscopy

36
Q

What does MRS rely on?

A

The individual resonance properties of certain molecules within brain tissue

37
Q

Give three examples of molecules that have known resonance properties?

A
  • Lactate
  • Choline
  • Creatinine
38
Q

What can MRS detect?

A

High levels of metabolites or other target molecules in conditions

39
Q

Give 5 examples of conditions that might have high levels of metabolites/other target molecules that might be picked up by MRS?

A
  • HIE
  • Brain injury
  • Epilepsy
  • Metabolic disorders
  • MS
40
Q

What does raised lactate on MRS signal?

A

A metabolic disorder

41
Q

What is a promising area of research with MRS?

A

Into tumours, as choline signals are often elevated in tumour tissue

42
Q

Is MRS widely available?

A

No, restricted to larger research centres

43
Q

How does PET imaging work?

A

A labelled radioactive tracker is injected into the body, which gives off gamma rays that are detected by a scanner

44
Q

What does the information gained from PET imaging depend on?

A

What molecule the tracker was attached to

45
Q

Give an example of a molecule a tracker might be attached to on PET, and what these images would reflect?

A

Flurodeoxyglucose

Images will reflect regional glucose uptake, and therefore the metabolic activity of the tissue

46
Q

What is the main indication of PET scanning in paediatric neurology?

A

To identify precise areas of seizure onset in focal epilepsy, therefore identifying possible targets for epilepsy surgery

TAS Neurology (11 decks)

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