Neuroradiology

Question 1

What are some indications that a patient should go for imaging?

Answer 1

Headache or raised ICT
Seizures (developmental or tumours)
Weakness or stroke
Trauma (bleed, mass effect, fracture)
Loss of consciousness
Post-operative collection or bleed

Question 2

What are some causes of headaches or raised ICT?

Answer 2

Mass, bleed, hydrocephalus, venous thrombosis, infection, other changes causing oedema

Question 3

What kind of view does a CT give?

Answer 3

Axial acquisition with 3D reconstruction

Question 4

What are the benefits of a CT scan?

Answer 4

Excellent bony detail and spatial resolution

Fast and compatible with emergency equipment

Question 5

What are the drawbacks of CT scans?

Answer 5

Poor soft tissue detail and contrast resolution
No direct multiplanar acquisition
Gives dose of radiation

Question 6

What are the benefits of MRI scans?

Answer 6

Excellent contrast and soft tissue resolution
Excellent depiction of anatomy
Multiplanar capability
Shows marrow and cord pathologies

Question 7

What are the drawbacks of doing an MRI?

Answer 7

Less bony detail and spatial resolution
Not compatible with pacemakers or most emergency equipment
Slower than CT

Question 8

How does an MRI give a view of the body?

Answer 8

Different sequences using a combination of technical parameters = each sequence is unique and gives different info

Question 9

What are some features of a hyperintense (bright) MRI view of T1?

Answer 9

Can see fat, methemglobin, mineral deposition, melanin and highly proteinaceous fluid
Contrast material is gadolinium

Question 10

What are some features of a hypointense (dark) MRI view of T1?

Answer 10

Shows water and paucity of mobile protons

High flow

Question 11

What are some features of a hyperintense MRI view of T2?

Answer 11

Visualises the fact that there is more water and less tissue

Shows fat = can be suppressed by design

Question 12

What are some features of hypointense MRI view of T2?

Answer 12

Shows some blood products, mineral depositions and paucity of water or mobile protons
High flow

Question 13

What are some features of magnetic resonance angiography?

Answer 13

Continguous axial source images reformatted to maximum intensity projections (MIP) = multiple projections allow 3D-like display

Question 14

What are the areas of the brain commonly affected by trauma?

Answer 14

Lateral midbrain
Inferior cerebellum and adjacent tonsil
Midline superior cerebral cortex