Neuroradiology

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Neuroradiology

  1. 1. NeuroradiologyNeuroradiology Natasha Wehrli, MS4Natasha Wehrli, MS4 University of Pennsylvania School of MedicineUniversity of Pennsylvania School of Medicine
  2. 2. Q: What is radiology?Q: What is radiology?  Answer (from Wikipedia):Answer (from Wikipedia): Radiology is the branch of medical science dealing with the medical use of radiation devices and other forms of energy for the purpose of obtaining visual information as part of medical imaging. Interventional radiology is the performance of medical procedures with the help of medical imaging.  My answer: the coolest field of medicine ever!
  3. 3. What is a neuroradiologist?What is a neuroradiologist?  A neuroradiologist is a radiologist who specializes in the use of x-rays and other scanning devices for the diagnosis and treatment of diseases of the nervous system.  A neuroradiologist must be concerned with the clinical imaging, therapy, and basic science of the central and peripheral nervous system, including but not limited to the brain, spine, head and neck.
  4. 4. Goals/ObjectivesGoals/Objectives  Review basic anatomic landmarks in theReview basic anatomic landmarks in the brainbrain  Learn the three different orientationsLearn the three different orientations neuroradiologists use to view images ofneuroradiologists use to view images of the brainthe brain  Be able to distinguish between a CT scan,Be able to distinguish between a CT scan, T1-weighted MR image, and a T2-T1-weighted MR image, and a T2- weighted MR image of the brainweighted MR image of the brain
  5. 5. OrientationOrientation QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture.
  6. 6. Sagittal PlaneSagittal Plane
  7. 7. Coronal PlaneCoronal Plane
  8. 8. Axial (Transverse) PlaneAxial (Transverse) Plane
  9. 9. What is a CT (or CAT) scan?What is a CT (or CAT) scan?  CT stands forCT stands for “computed“computed tomography” - this istomography” - this is a complex machinea complex machine that uses x-rays tothat uses x-rays to create three-create three- dimensional imagesdimensional images of the bodyof the body
  10. 10. What is bright/dark on CT?What is bright/dark on CT?  The more dense theThe more dense the tissue, the brighter ittissue, the brighter it looks on CTlooks on CT  Any calcified structureAny calcified structure (like the skull)(like the skull) appears brightappears bright  New hemorrhage inNew hemorrhage in the brain is also brightthe brain is also bright  Water (or CSF) looksWater (or CSF) looks dark on CTdark on CT
  11. 11. What is MR?What is MR?  MR stands forMR stands for “magnetic resonance”“magnetic resonance” - this is a tool that- this is a tool that uses magnetic fieldsuses magnetic fields created by a giantcreated by a giant magnet to producemagnet to produce three-dimensionalthree-dimensional images of the humanimages of the human bodybody
  12. 12. The two most common typesThe two most common types of MR images are…of MR images are…  T1-weighted MR imagesT1-weighted MR images-- useful to look at normaluseful to look at normal anatomyanatomy of the brainof the brain  T2-weight MR imagesT2-weight MR images -- useful to look at abnormaluseful to look at abnormal processes (orprocesses (or pathologypathology)) in the brainin the brain
  13. 13. What is bright/dark on T1?What is bright/dark on T1?  Fat is brightFat is bright  White matter (innerWhite matter (inner part of brain) ispart of brain) is brighter than graybrighter than gray matter (cortex ormatter (cortex or outer part of theouter part of the brain)brain)  Water (CSF) is darkWater (CSF) is dark
  14. 14. What is bright/dark on T2?What is bright/dark on T2?  Water is brightWater is bright  Blood is brightBlood is bright  White matter is darkerWhite matter is darker than gray matterthan gray matter
  15. 15. Other Studies - AngiogramOther Studies - Angiogram  Some neurologistsSome neurologists just want to look atjust want to look at blood vessels in theblood vessels in the brainbrain  They can inject aThey can inject a contrast agent andcontrast agent and then use x-rays to seethen use x-rays to see the blood flowingthe blood flowing inside the arteryinside the artery
  16. 16. Interventional RadiologyInterventional Radiology  InterventionalInterventional radiologists use x-radiologists use x- rays and otherrays and other imaging tools in theimaging tools in the operating room tooperating room to perform minimallyperform minimally invasive surgeryinvasive surgery
  17. 17. Neuroradiology is a rapidlyNeuroradiology is a rapidly advancing field of medicine…advancing field of medicine…  Scientists are creating stronger and strongerScientists are creating stronger and stronger magnets to create clearer MR images of themagnets to create clearer MR images of the brain!brain!
  18. 18. Neuroradiology is a rapidlyNeuroradiology is a rapidly advancing field of medicine…advancing field of medicine…  You can also use MR to show areas of blood flowYou can also use MR to show areas of blood flow in different regions in the brain - this is calledin different regions in the brain - this is called functional MRIfunctional MRI  What part of the brain is abnormal in theseWhat part of the brain is abnormal in these images? What does this patient have?images? What does this patient have?
  19. 19. NeuroradiologyNeuroradiology  At the end of today, you should be able toAt the end of today, you should be able to identify the 3 different orientations of the brain asidentify the 3 different orientations of the brain as well as a few important structures in the brainwell as a few important structures in the brain  You should also attempt to distinguish CT, T1-You should also attempt to distinguish CT, T1- weighted MR and T2-weighted MR imagesweighted MR and T2-weighted MR images Consider a career in neuroradiology! It’s a veryConsider a career in neuroradiology! It’s a very rewarding, high-tech specialty with a lot of funrewarding, high-tech specialty with a lot of fun problem-solving. Neuroradiologists also play anproblem-solving. Neuroradiologists also play an important role in diagnosing diseases andimportant role in diagnosing diseases and helping patients get the most appropriatehelping patients get the most appropriate medical care.medical care.
  20. 20. Thanks!Thanks! References/ResourcesReferences/Resources http://www.images.http://www.images.googlegoogle.com.com http://www.http://www.wikipediawikipedia.com.com

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