Neuroradiology Flashcards
What imaging modality is best for emergency situations and/or for a patient with suspected head trauma?
CT
What type of study is this?
CT
What imaging modality is helpful for patients with Alzheimer’s?
PET - it can show areas of hypermetabolism or PIB binding to amyloid
Which imaging modality has the best soft tissue resolution?
MRI
State the color of each of the following on a T1, T2, and FLAIR MRI:
- CSF
- Gray matter
- White matter
- Bone
T1
CSF is dark
Gray matter is gray
White matter is white
Can’t see bone
T2
CSF is bright
Gray matter is white
White matter is gray
Can’t see bone
FLAIR - a T2 MRI where the CSF is made dark
CSF is dark
Gray matter is white
White matter is gray
Can’t see bone
What is DWI and what is it good for?
Detects the movement of water across membranes, which happens in neuronal cell death. It is 95% sensitive for ischemic stroke.
What imaging modality is this?
T2 MRI
What imaging modality is this?
FLAIR - the white matter is gray and the gray matter is white (like a T2) but the CSF is dark!
Why would you use IV gadolinium-enhanced MRI?
To show areas of bleeding that do not show up on a normal MRI - gadolinium won’t cross the BBB unless it is compromised.
What kind of imaging modality is this?
DWI - looks like a FLAIR but you can’t see bone, fat, or skin for shit
Describe the key differences amongst the different angiography techniques (CTA, catheter angiogram, MRA).
CTA - used when you suspect that your patient has a stroke but the CT comes back negative for hemorrhage; allows you to look for thrombotic blockage quickly.
Catheter angiogram is best for visualizing small aneurysms or MVAs that a CTA doesn’t pick up; interventions can also be done at the same time (coiling, etc.).
MRA is also good for looking at small aneurysms but is less invasive than catheter angiograms.
A 65 year old male presents to your ER with 90 minutes of slurred speech and right-sided weakness. Initial head CT is negative. The neurologist asks you to work up the patient for a stroke. What is the most appropriate follow-up imaging exam?
a) Carotid doppler US
b) MRI
c) MRA
d) CTA
e) Catheter Angiogram
d) CTA is the fastest way to find a thrombus
A 28 year old female is unconscious after collapsing while running; Initial head CT shows subarachnoid hemorrhage and the CTA is negative. The neurosurgeon remains worried about a small aneurysm or vascular malformation. Which is the best follow-up imaging modality?
a) Repeat CTA
b) MRA
c) Transcranial Doppler US
d) Catheter Angiogram
d) Catheter angiogram is good for finding small aneurysms or MVAs and also allows for interventions at the same time
A 38 year old woman presents with right facial numbness. She developed left optic neuritis, or central visual loss within her left eye two years ago. You suspect that she may have multiple sclerosis (MS). Which scan would you order to investigate?
a) MRI
b) PET
c) CT
d) CTA
e) Ultrasound
a) MRI
A 58 year old patient presents with 2 hours of vertigo, nystagmus, and dysarthria. The head CT was negative. The neurology team would like a stat MRI for definitive diagnosis of ischemic stroke. Which sequence will be most helpful?
a) T1
b) T2
c) FLAIR
d) DWI
e) GRE
d) DWI
