Which modality? (Final Exam) Flashcards
Acute brain bleeds #1
CT
Acute brain bleeds #2
Diffusion weighted MRI
Looking for hematoma AROUND the brain
CT
Stroke or ruptured aneurysm IN the brain
EQUAL: CT and diffusion weighted MRI
Head trauma first 48 hours
CT
Head trauma after 48 hours
MRI
Brain aneurysm #1
MRA
Brain aneurysm #2
MRI
Brain aneurysm #3
CT
MS #1
MRI
MS #2
CT (not as sensitive)
Arnold-Chiari #1
MRI definite first
Arnold-Chiari #2
CT distant second
Multiple Sclerosis
Image brain first since thats usually where plaque starts
Arnold-Chiari
Increased predisposition if other anomalies are present. In order to rule out a syrinx both brain and C-spine need imaging. Type 1: 4mm or less. Type 2: 5mm or more
Brain tumor #1
MRI
Brain tumor #2
CT close second
Vertebral Artery Dissection or Stenosis #1
MRA (not great)
Vertebral Artery Dissection or Stenosis #2
MRI (not great)
Carotid Artery Stenosis #1
Ultrasound (cheaper if following progress overtime)
Carotid Artery Stenosis #2
MRA (more accurate but more expensive)
Finding a fracture #1
CT
Finding a fracture #2
EQUAL: Bone scan & MRI
Cervical spine fractures
CT always #1
15-30% of fx will never be detected on plain film. They are often associated with other visible (on plain film) fx
Aging a fracture: First 4-6 wks
MRI (to detect bone marrow edema)
Aging a fracture: 6 weeks or more
Bone scan (note: for a child every growth plate will be hot on bone scan)
Fatigue/stress fracture #1
MRI (b/c it provides additional info if negative for stress fx)
Fatigue/stress fracture #2
Bone scan
Disc herniation #1
MRI by a long shot! But it doesn’t change clinical outcome so save money and don’t bother.
Disc herniation #2
CT distant distant second
Spinal stenosis #1
MRI (especially required for px with cancer phobia)
Spinal stenosis #2
CT
Spinal stenosis central and lateral
Central - DDD
Lateral - Facet OA
Finding OPLL
CT
Impact of OPLL on neural structures
MRI
OPLL on imaging sequences
Dark because of calcium
Imaging with suspicion of pathology involving Calcium
CT