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Neuro radiology neuroimaging
- 1. By : Marwa Mahmoud Khalifa Hematology & Internal Medicine Specialist
- 2. Plain X ray CT MRI US Angiography PET scan Modalities
- 3. Fractures of the bones of the skull Pituitary tumors Bone defects (birth/ Myeloma/metabolic) Evaluate the nasal sinuses Detect cerebral calcification . X ray skull
- 8. MM
- 10. Enlarged sella
- 11. CT
- 12. Unenhanced CT CT with contrast CT angiogram CT venogram Types of CT
- 13. Hemorrhage Ischemic stroke DLC Seizure Headache Unenhanced CT Indications
- 14. Assessment of intracranial mass lesion Primary malignancy vs. mets Abscess/infection eg. meningitis, toxoplasmosis (HIV+) Enhanced CT Indications
- 15. Spontaneous SAH Cerebral artery aneurysm AVM Ischemic stroke Occlusive thrombus Dissection CT Angiography Indications
- 16. Dural venous sinus thrombosis CT Venography Indications
- 19. A. Orbit B. Sphenoid Sinus C. Temporal Lobe D. External Auditory Canal E. Mastoid Air Cells F. Cerebellar Hemisphere
- 20. A. Frontal Lobe B. Frontal Bone (Superior Surface of Orbital Part) C. Dorsum Sellae D. Basilar Artery E. Temporal Lobe F. Mastoid Air Cells G. Cerebellar Hemisphere
- 21. A. Falx Cerebri B. Frontal Lobe C. Anterior Horn of Lateral Ventricle D. Third Ventricle E. Quadrigeminal Plate Cistern F. Cerebellum
- 22. A. Anterior Horn of the Lateral Ventricle B. Caudate Nucleus C. Anterior Limb of the Internal Capsule D. Putamen and Globus Pallidus E. Posterior Limb of the Internal Capsule F. Third Ventricle G. Quadrigeminal Plate Cistern H. Cerebellar Vermis I. Occipital Lobe
- 23. A. Genu of the Corpus Callosum B. Anterior Horn of the Lateral Ventricle C. Internal Capsule D. Thalamus E. Pineal Gland F. Choroid Plexus G. Straight Sinus
- 24. A. Falx Cerebri B. Frontal Lobe C. Body of the Lateral Ventricle D. Splenium of the Corpus Callosum E. Parietal Lobe F. Occipital Lobe G. Superior Sagittal Sinus
- 25. A. Falx Cerebri B. Sulcus C. Gyrus D. Superior Sagittal Sinus
- 26.
- 33. Metallic Artefact (star shaped artifact)
- 36. 1- Acute SDH high density fluid collection layering along the cerebral convexity, 2- Subacute SDH (1-2 weeks) “isodense” to grey matter 3- Chronic SDH (> 2 weeks) “hypodense” to gray matter 4- Acute-on-chronic hyperdense acute hemorrhage intermixed or layering dependently within the chronic collection. SDH – CT Features
- 40. Add htn image here Intracerebral hemorrhage
- 41. Ischemic Left MCA Stroke
- 44. Brain oedma
- 45. Hydrocephalus
- 46. Brain Abscess
- 47. Primary tumours: Astrocytoma Glioblastoma Oligodendroglioma Meningioma Secondary tumours (mets): Most commonly supratentorial Mass Lesions
- 48.
- 49.
- 50. The two most common types of MR images are… T1-weighted MR images- useful to look at normal anatomy of the brain T2-weight MR images - useful to look at abnormal processes (or pathology) in the brain
- 51. What is bright/dark on T1? Fat is bright White matter (inner part of brain) is brighter than gray matter (cortex or outer part of the brain) Water (CSF) is dark
- 52. What is bright/dark on T2? Water is bright Blood is bright White matter is darker than gray matter
- 53. Brain tumor
- 54. T1 SAGITTAL MR Pituitary Adenoma
- 55. T2* MRV on a Seizure Patient
- 57. Conventional Angiography Aneurysm Round (‘berry’) shape At Vessel bifurcation
- 58. Cranial ultrasound Cranial ultrasound uses reflected sound waves to produce pictures of the brain and the inner fluid chambers (ventricles) through which cerebrospinal fluid (CSF) flows. This test is most commonly done on babies to evaluate complications of premature birth. In adults, cranial ultrasound may be done to visualize brain masses during brain surgery.
- 59. INDICATIONS Prematurity Increased head circumference Persisting large fontanelle Trauma Known hypoxia Follow up of known pathology Failure to thrive Suspected intracranial mass or infection
- 60. LIMITATIONS If the anterior fontanel is very small or closed your visibility will be reduced or completely obscured. Even with a large fontanelle, the peripheral extremes of the brain are obscured from view.
- 61. Doppler of the carotid bifurcation
- 63. Procedure Patients should fast for at least 4 hrs Check blood glucose levels prior to the FDG administration. When hyperglycemia is present (>160 mg/dl), there is increased competition of elevated plasma glucose with FDG at the carrier enzyme Therefore FDG uptake is reduced . Empty the bladder for maximum comfort during the study. Advice the patient to void again after the scanning session to minimize radiation exposure. The patients should be positioned comfortably in a quiet dimly lit room several minutes before FDG-administration and during the uptake phase of FDG (at least 20 min). They should be instructed not to speak, read or otherwise be active.
- 64. Indications A..Epilepsy. B. Dementia. Indications include early diagnosis and differential diagnosis of dementing disorders, like Alzheimer's disease and fronto-temporal dementia . C. Neurooncology. FDG-PET is predominantly used in differential diagnosis of cerebral lumps, detection of viable tumor tissue (i.e. recurrence) and for non-invasive grading D. FDG-PET is clinically used for a number of other indications, e.g. movement disorders or cerebrovascular disease .
- 65. Contra indications: A. Pregnancy (mothers should interrupt breast feeding for 24hrs if SPET is indicated) B. Evident lack/unability of cooperation Patient should be able to lie still for 30 min to 1 hr. If sedation is necessary it should be performed as late as possible. It should be intended to administer FDG prior to sedation