Neuroradiology & Anatomy - Strottmann Flashcards

1
Q

What type of electromagnetic wave does CT use? MRI?

A

CT: X-rays

MRI: Radio waves & Magnetic fields

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2
Q

Describe the difference in the size of a CT machine vs. an MR imager.

A
  • CT is a circular gantry (donut)
    • Not overly deep
  • MRI is a cylindrical magnet (coffin)
    • Add in the head restraints typically used to prevent motion blur in imaging, and one can see how claustrophobia can be an issue for some patients
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3
Q

Contrast CT and MRI in terms of time needed for a typical set of scans.

A
  • CT: Fast. A few minutes.
  • MRI: Slower. Several minutes, perhaps up to half an hour
    • May present trouble regarding certain patients; e.g. psychotic, drunk, etc.
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4
Q

Compare CT and MRI in terms of the radio-contrast that can be used.

A

CT: Iodine

MRI: Gadolinium

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5
Q

How do CT and MRI compare in terms of expense?

A

MRI is more expensive than CT.

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6
Q

What anatomic planes does CT scan in?

What about MRI?

A
  • CT: Scan is in axial plane
    • Images in other planes are generated digitally from axial data
  • MRI: Scans in multiple planes: axial, coronal, sagittal (& oblique)
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7
Q

Compare CT and MRI in terms of how multiple image data sets are generated.

A
  • CT: A single scan is done (maybe two, if contast is given). From there, digital manipulation of the data is used to generate various “windows” (brightness & contrast settings) that are useful for visualizing different structures.
  • MRI: A seperate scan (3 to 8+) is done for each set of images.
    • Multiple planes
    • Various pulse seqeunces
    • Each image set is viewed with only one window.
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8
Q

When viewing axial images, what should you always remember that your perspective is?

A
  • Pt laying on their back
  • You’re standing at the foot end of the table
  • You’re looking up at the undersurface of the anatomic slide in question
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9
Q

Compare the strengths of CT vs. MRI in terms of which tissues each is useful for looking at.

A
  • CT
    • Bone
    • Hemorrhage
    • Trauma
    • Fluid (e.g. CSF)
    • +/- soft tissue
  • MRI
    • Soft tissues
      • Includes bone marrow
    • Better contrast enhancement
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10
Q

Rank the follow tissue types in order of brightest to darkest when looking at a CT image:

  • CSF
  • Air
  • Gray matter
  • White matter
  • Hemorrhage
  • Fat
  • Bone
A

From brightest to darkest on CT:

  1. Bone (bright white)
  2. Hemorrhage
  3. Gray matter
  4. White matter
  5. CSF
  6. Fat
  7. Air (black)

Note that **gray matter **is (unintuitively) slightly brighter than white matter on CT.

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11
Q

Rank the follow tissue types in order of brightest to darkest when looking at a T1W1 MRI image:

  • CSF
  • Air
  • Gray matter
  • White matter
  • Fat
  • Bone
A

From brightest to darkest on T1W1 MRI:

  1. Fat (white)
  2. White matter
  3. Gray matter
  4. CSF
  5. Air & cortical bone (black)

Note that **white matter **is slightly brighter than gray matter on T1W1 MRI.

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12
Q

Rank the follow tissue types in order of brightest to darkest when looking at a T2W1 MRI image:

  • CSF
  • Air
  • Gray matter
  • White matter
  • Fat
  • Bone
A

From brightest to darkest on T2W1 MRI:

  1. CSF (bright)
  2. Fat
  3. Gray matter
  4. White matter
  5. Air & cortical bone (black)

Note that **grey matter **is (unintuitively) slightly brighter than white matter on T1W1 MRI.

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13
Q

While looking at an axial slice image of a patient’s head, you note a bright ring encircling the brain. What would you conclude this ring to be if you were looking at:

  • A CT image?
  • An MRI image?
A
  • CT: The skull
    • Bone is brighest on CT!
  • MRI: The subcutaneous fat of the head (not the skull!)
    • Fat is bright on MRI!
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14
Q

What is the Diffusion Weighted Imaging form of MRI most useful for detecting in terms of neurological pathology?

A

Early identification of ischemic stroke

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15
Q

How can you find the central sulcus on an axial image?

A

Look for an “omega-shaped” (hook-like) sulcus extending from each lateral edge of the brain about mid-way along the ventral-dorsal axis. The central sulci typically should not reach the midline of the brain.

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16
Q

What is a major contraindication for CT? For MRI?

A
  • CT: Anaphylactic reaction to iodine contrast
    • Mild allergies can be coutneracted with a short course of immunosuppression using antihistamines and prednisone prior to administration of iodine
  • MRI: Metal implant / pacemaker etc.
    • Gadolinium anaphylaxis and allergies are much rarer than those to iodine