Neuroradiology Flashcards

1
Q

Describe the indications for plain radiographs?

A
Stroke
Head Trauma
Headache
Cancer
Post-sugerical bleeds or hydrocephalus
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2
Q

What are the pros/cons of plain radiographs?

A
  • Quick
  • Widely available
  • No soft tissue or functional details
  • Not as detailed as CT/MRI
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3
Q

What are the main types of MRI?

A
  • Functional MRI
  • Diffusion weighted MRI (DW-MRI)
  • Diffusion Tensor Imaging (DTI)
  • T1 vs T2
  • FLAIR
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4
Q

Whats the difference between T1/T2 MRIs?

A

T1

  • Fluid is black
  • Bone is black surrounded by white fat

T2:

  • CSF/Water are white
  • Brain tissue is darker
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5
Q

What is FLAIR MRI?

A

Fluid Attenuated Inversion Recovery

Basically nulls out fluids like CSF so you can see periventricular lesions better

Looks like T2 but with black CSF

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6
Q

What does a functional MRI do?

A

Detects activity in different parts of the brain in real time.
So you can see what lights up during a certain action

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7
Q

What does a DW-MRI do?

A

Shows up diffusion of water and small molecules

Useful for spotting cytotoxic oedema as part of the necrosis in infarction

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8
Q

What does DTI MRI do?

A

Allows you to build a map of the brains white matter tracts location and orientation
So you can track an individual tract

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9
Q

When would you use MRIs?

A
  • Focal Epilepsy
  • Demylination e.g. MS
  • Developmental/Congenital Malformations
  • Red Flag Headache or Raised ICP
  • Spinal Cord Diseases
  • Cancers
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10
Q

Pros and cons of MRI?

A
  • No radiation
  • Lots of sequences to detect many different soft tissue and functional details
  • Cant tolerate metals of implanted electronics
  • Slow
  • Expensive
  • Not movement tolerant
  • Not good for the pregnant, claustrophobic or tattooed
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11
Q

How does a CT appear?

A
  • White Bone
  • Black CSF & Air

Grainy & Shows subtle grey/white matter differentiation

Metal shows up as white starburst artefacts

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12
Q

Pros & Cons of CT?

A
  • Fast
  • Tolerates metals & electronic
  • Good for Haemorrhage
  • Radiation
  • Not as available as X-ray
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13
Q

What is CT/MRI Perfusion imaging?

A

Shows up blood flow in ml/100g/min

Used for stroke (decreased perfusion to affected area)
And Tumours (Increased perfusion, level can indicate aggresiveness)
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14
Q

Types of cerebral Angiography

A

Digital Subtraction Angiography with CT images and dye

MRA

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15
Q

What is cerebral angiography used for?

A
  • Aneurysms
  • Arteriovenous Malformations
  • Carotidcavernouis fistulas
  • Unstoppable epistaxis

Basically after a bleed or stroke in which theres reason to believe its not a primary bleed

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16
Q

What are the main types of nuclear medicine?

A
  • Ioflupane Scan
  • PET Scan
  • SPECT
17
Q

What does an ioflupane scan do?

A

Detects activity in the basal ganglia

Reduced activity diagnoses Parkinson’s

18
Q

What does a PET scan show?

A

Glucose metabolism

  • Tumour (metastases and post-resection)
  • Inflammation
  • Infection
19
Q

What is SPECT and what does it show?

A

Single Photon Emission CT

Detects perfusion in the brain
Particularly for the early stages of alzheimers where atrophy hasn’t yet become visible

Fuzzy very colourful images

20
Q

Pros and cons of Nuclear Medicine?

A
  • Great physiological info
  • Poor anatomical info
  • Costly
  • Tracers can be costly/slow to obtain
21
Q

When would you use an ultrasound in neuro?

A
  • Through babies fontanelles with colour shift imaging to check CSF/blood flow
  • Ocular US
  • Carotid US with colour shift imaging for carotid stenosis
22
Q

Pros and cons of Ultrasound?

A

Pros

  • No radiation
  • Easy to perform on neonates
  • Tolerant to movement
  • Cheaper than most other scan

Cons:

  • Needs an expert to administer and interpret
  • Useless for seeing in head after fontanelles close