Neuroradiology

Question 1

List indications to perform a CT scan

Answer 1

Stroke
Head trauma
Headache - red flags for suspected tumour or subarachnoid haemorrhage
Cancer
Post-surgical: hydrocephalus, haemorrhage

Question 2

what are reasons perhaps not to perform a CT scan?

Answer 2

seizure-usually choose MRI
primary idiopathic generalised epilepsy – no imaging
Minor head trauma exclusion eg open skull fracture

Question 3

List indications to perform an MRI scan

Answer 3

Epilepsy
Spine
Demyelination
Cancer
Headache
Stroke
Paediatric neurology

Question 4

what are state contraindications to perform an MRI scan?

Answer 4

implanted electronics eg most cardiac pacemakers
Moveable metallic implants eg
Aneurysm clips, heart valves
Claustrophobia, pregnancy, tattoos

Question 5

what are the uses of angiography in the diagnosis of neurological pathology?

Answer 5

Large vascular (arterial and venous) abnormalities
Aneurysm
Arteriovenous malformation
Carotidocavernous fistula 
Unstoppable epistaxis

Question 6

what can CT perfusion diagnose?

Answer 6

Stroke – decreased perfusion

Tumour – increased perfusion indicates angiogenesis and a more aggressive tumour

Question 7

what is PET used for?

Answer 7

PET is usually used to map out glucose usage Increased metabolism is seen in:
Tumour
Inflammation
Infection

Question 8

what are the advantages of Plain radiographs?

Answer 8

Almost universal availability
Fast
Sequential images in subtraction angiography

Question 9

what are the disadvantages of Plain radiographs?

Answer 9

Lacks soft tissue detail

Question 10

what are the advantages of Ultrasound?

Answer 10

No radiation
Less expensive equipment
Can be performed in the neonatal unit
Movement tolerant

Question 11

what are the disadvantages of Ultrasound?

Answer 11

Requires a wide
enough open fontanelle i.e. up to about 1 year old
Image quality and interpretation based on operator skill

Question 12

what are the advantages of CT?

Answer 12

Rapid
Metal and pacemaker
tolerance
Good for demonstrating acute haemorrhage

Question 13

what are the disadvantages of CT?

Answer 13

Radiation 2mSv
More expensive
cumbersome equipment

Question 14

what are the advantages of Radionuclide radiology?

Answer 14

Physiological information:
Glucose metabolism
Perfusion
Dopamine reuptake receptors

Question 15

what are the disadvantages of Radionuclide radiology?

Answer 15

Unclear anatomical
information
Medium cost of equipment Radiotracers can be very expensive

Question 16

what are the advantages of MRI?

Answer 16

No radiation
Soft tissue differentiation Physiological information:
• blood flow
• diffusion restriction
• metabolite concentrations

Question 17

what are the disadvantages of MRI?

Answer 17

Poor tolerance of metalwork 
Magnetic sensitive electronics may fail or are contraindicated
Least movement tolerance 
Slow, must limit sequences 
Most expensive equipment