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MD4001 Clinical > Neuroimaging > Flashcards

Neuroimaging Flashcards

(48 cards)

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1
Q

What factors should you consider in imaging?

A
  • Anatomy and structure
  • Symmetry
  • Incidentalomas (something that is a surprise/not meant to be there)
  • Availability (e.g rural areas)
  • Practicality and cost (cheaper and quicker to acquire than MRIs)
  • Side effects
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2
Q

WHat are the different planes of the body?

A
  • Sagittal
  • Transverse
  • Coronal
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3
Q

What is the increase in dosage of radiation in a CT scan of the head in comparison with a CXR?

A

200x more

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4
Q

What view is a CT?

A

Caudal view

  • Looking from feet
  • L/R are opposite
  • Slightly diagonal
  • Orbitomeatal line
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5
Q

What is the age affect?

A
  • Normal atrophy of the brain with age
  • Alcohol and trauma can accelerate
  • May be disproportionate for age - neurodegenerative disorders
  • Ventricles become larger
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6
Q

What is denser/lighter on a CT; white or grey matter?

A
  • Grey is denser/lighter than white
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7
Q

What is denser/lighter on a CT; CSF or water?

A

CSF

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8
Q

What is the darker shade on a CT in and around the eye?

A

Retrobulbar fat

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9
Q

What does the falx cerebri do?

A

Divides frontal lobe into left and right

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10
Q

What is at risk of herniating down into the foramen magnum when the intracranial pressure is raised?

A

Uncus of temporal lobe

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11
Q

What does the tentorium cerebelli do?

A

Extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes

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12
Q

What does the cerebellar vermis do?

A

Connects left and right sides of cerebellum

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13
Q

What structure divides the lateral ventricles?

A

Septum pellucidum

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14
Q

What do the sylvian/lateral fissures do?

A

Divide temporal lobes from the frontal and parietal lobes

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15
Q

Where is the CSf filled quadrigeminal cistern located?

A

Dorsal wall of midbrain

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16
Q

What is the head of the caudate nucleus and lentiform nucleus divided by?

A

Internal capsule

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17
Q

What does ABCS refer to when interpreting MRIs and CTs of the brain?

A
  • A - adequacy, alignment, artefact
  • B - bones, blood, brain
  • C - cisterns and ventricles
  • S - subcutaneous and surfaces, symmetry
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18
Q

What does artefact apply to?

A
  • Beam hardening artefact - posterior fossa particularly , streaking like from bone
  • Motion - confused patient, children causes a mass of grey often
  • Medical - metal clips, intraventricular shunts can cause a bright glare around the tissue
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19
Q

What does a bone window mean?

A
  • Allows us to get a clearer view of the bones in the skull (focus on higher range of Hounsfield Units/HU)
  • Good when looking at trauma to the skull
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20
Q

What does a extradural haematoma look like on a CT?

Study These Flashcards
A
  • Between skull and outer layer of dura

- Biconvex - limited by cranial sutures forms lens like shape

21
Q

What does a subdural haematoma look like?

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A
  • Between dura and arachnoid
  • Crescent - limited only by dural reflections (falx/tentorium)
  • Can be chronic or acute
22
Q

What can cause a subdural haematoma?

Study These Flashcards
A

A fall (elderly patient, sports injury)

23
Q

What is a diffuse axonal injury?

Study These Flashcards
A
  • Traumatic brain injury, due to shearing forces
  • Poor grey-white matter differentiation, loss of sulci
  • Brain expands
  • May be associated with haemorrhage
  • Management largely supportive
24
Q

Where does the blood collect in a subarachnoid haemorrhage?

Study These Flashcards
A

Cisterns (looks like a star)

25
What does obstructive hydrocephalus look like?
Blockage in ventricular system causing huge enlargement of lateral ventricles
26
How is hydrocephalus treated surgically?
Interventricular shunt (hole in skull and tube in ventricle to drain off the excess CSF)
27
What do you look for when looking at S - subcutaneous and soft tissue?
- Skin/subcutaneous lesions (e.g epidermal cyst) - Orbit (e.g melanoma mestastasis, greyish structure behind globe) - Sinuses (e.g maxillary sinusitis) - Nasopharynx and oropharynx
28
What is a ring-enhancing lesion?
- Abnormal radiologic sign on MRI or CT scans obtained using radiocontrast - Tumour or abscess? - MRI required to differntiate further
29
What can a ring-enhancing lesion with a thick and solid part on the ring?
Tumour
30
Describe a meningioma?
- Typically benign - slow-growing - Patient often asymptomatic - tumour discovered incidentally - Good prognosis following surgical removal - Homogenous, well circumscribed, broad dural base
31
What percentage of strokes are haemorrhagic?
~15%
32
What are the risk factors for a stroke?
- Hypertension - Ischaemic stroke (haemorrhagic transformation) - Anticoagulation - Amyloid angiopathy
33
What percentage of strokes are ischaemic?
~ 85%
34
What is an ischaemic stroke?
- Blockage of cerebral arteries causes ischaemia of brain tissue - Thrombus may be seen as hyperdensity on scan
35
What is the Monroe-Kellie doctrine?
The sum of volumes of brain, CSF and intracerebral blood is constant
36
Is the age affect more marked in CT or MRI?
MRI - Superior soft tissue contrast - much more detail - White matter hyperintensities allowed ~1 per decade (more suggests neurodegenerative disorder)
37
What plane can an MRI be looked at though?
Any plane (usually looked at caudal view)
38
What should be considered before an MRI?
Safety - Pacemakers - Cochlear implants - Metal around eyes/head
39
What does a scanner measure in an MRI?
The speed at which protons return to their initial axis along the magnetic field. Different levels of speed = different contrasts
40
What are the different weights for an MRI?
T1: best for structural imaging, - Water is dark, grey matter is darker than white matter T2: good for identifying pathology - inflammation, oedema - Water is light, white matter is darker than grey matter - WW2 - Water White T2
41
What are DWI - diffusion weighted MRI and ADC - apparent diffusion coefficient?
- For acute strokes - show highlighted area that stroke has affected (less diffusion) - DWI - T2-based sequence that measures diffusion of water within tissues - ADC - calculated from DWI, shows pure diffusion - Acute stroke - highlighted
42
What is better at looking at bone MRI and CT?
CT
43
What can a venous sinus thrombosis be seen on?
MR venogram
44
What can increase the chances of a venous sinus thrombosis?
Pregnancy and oral contraceptive pill use
45
What does MS look like on imaging?
- White matter plaques can appear anywhere in CNS (brain or spinal cord) - T2/FLAIR - Hyperintense - T1 - Hypointense black holes, hyper in advanced disease
46
What can an MRI scan of the spinal cord be useful for ?
Diagnosing caudia equina syndrome
47
What is tractography?
- Shows direction of travel of white matter tracts using color imaging - Mostly used in research to see how different lesions can affect the brain
48
WHat does nuclear imaging (SPECT and PET) show?
- Involves injecing the patient with a radioactive substance - Radioactive substance highlights areas of biological activity (high blood flow)

MD4001 Clinical (4 decks)

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