Neuroradiology

Question 1

List some indications for a head scan

Answer 1

suspected tumour 
head trauma 
acute stroke 
headaches - suggesting tumour or subarachnoid haemorrhage 
cancer metastases 
post surgical eg hydrocephalus

Question 2

Reasons to not perform a head scan

Answer 2

minor head trauma exclusion criteria

seizure - usually MRI

Question 3

List some indications for MRI scan

Answer 3

paediatric neurology 
demyelination 
disc prolapse 
CNS tumours 
TIA 
headache 
epilepsy

Question 4

What can an MRI tell you about cancer?

Answer 4

aggressiveness, location, number

Question 5

Absolute contraindications for MRI scan

Answer 5

pacemaker
cochlear implant
reprogrammable shunt (relative)
moveable metallic implants eg aneurysm clip, heart valves

Question 6

Relative contraindications for an MRI scan

Answer 6

tattoos
pregnant
claustrophobic

Question 7

What can angiography be used for in terms of neurological pathology?

Answer 7

aneurysm
arteriovenous malformation
carotidocavernous fistula
unstoppable epistaxis

Question 8

Define perfusion

Answer 8

the volume of blood passing through a defined volume of tissue per unit time

Question 9

Units of perfusion

Answer 9

ml/100g of tissue/minute

Question 10

What imaging techniques can show perfusion?

Answer 10

CT and MRI

Question 11

List the 2 types of abnormal perfusion and conditions

Answer 11

stroke - decreased

tumour - increased

Question 12

3 scenarios in which glucose metabolism is increased

Answer 12

tumour
inflammation
infection

Question 13

What does a PET scan show?

Answer 13

glucose usage and metabolism

Question 14

Why is PET scan used after tumour resection?

Answer 14

to differentiate between granulation tissue and remaining tumour

Question 15

How would you identify an x-ray?

Answer 15

bones are white and superimposed
anatomy obvious
soft tissue grey
air black

Question 16

How would you identify a CT scan?

Answer 16

white ring of skull 
slightly grainy 
black CSF in sulci and ventricles 
grey brain with subtle white/grey differentiation 
air is black

Question 17

How would you identify an MRI image?

Answer 17

black skull with white ring of fat around
white CSF in T2
better grey/white differentiation

Question 18

How would you identify a PET image?

Answer 18

bright and varied colour fuzzy image

Question 19

How would you identify an ultrasound image?

Answer 19

wedge shaped

objects blocking US waves eg bone and stones make a downward shadow

Question 20

Advantages and disadvantages of plain radiography?

Answer 20

available and fast

lacks soft tissue detail

Question 21

Advantages and disadvantages of ultrasound

Answer 21

fast, neonatal unit, moveable, no radiation, cheap

requires a wide open fontanelle, operator dependent

Question 22

Advantages and disadvantages of CT

Answer 22

rapid, metal tolerant, acute haemorrhage

radiation, expensive

Question 23

Advantages and disadvantages of radionuclide radiology

Answer 23

glucose metabolism and perfusion

unclear anatomy, medium cost, expensive radiotracers

Question 24

Advantages and disadvantages of MRI

Answer 24

no radiation, soft tissue, physiological info

time taken, metal and implants contraindicated