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C1

  1. 1. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 1 Tool for DNB Practical examination in pediatrics CT in pediatrics
  2. 2. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 2 Identify: A B C D E F G H I J k
  3. 3. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 3
  4. 4. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 4 D E A B C F G H I
  5. 5. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 5
  6. 6. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 6 WHAT IS THE ROLE OF NEUROIMAGING IN MENINGITIS? WHAT IS THE ROLE OF NEUROIMAGING IN DIAGNOSING EARLY TBM? WHAT ARE THE FEATURES OF BASAL EXUDATES ON CT/MRI?
  7. 7. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 7 Meningitis (tuberculous)
  8. 8. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 8 Meningitis
  9. 9. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 9 Meningitis with Hydrocephalus
  10. 10. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 10 Subdural Effusion Secondary To Meningitis
  11. 11. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 11 IN CASE OF HEALTHY CHILDREN WITH SEIZURES ONE SHOULD SUSPECT AN INTRACRANIAL GRANULOMA. INTRACRANIAL GRANULOMA- A CLINICAL DILEMMA. IS IT A TUBERCULOMA OR NEUROCYSTICERCOSIS? HOW WOULD NEUROIMAGING HELP?
  12. 12. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 12 TUBERCULOMA
  13. 13. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 13 TUBERCULOMAS
  14. 14. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 14 NEUROCYSTICERCOSIS
  15. 15. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 15 NEUROCYSTICERCOSIS
  16. 16. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 16 NEUROCYSTICERCOSIS
  17. 17. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 17 NEUROCYSTICERCOSIS STAGES CT MR VESICULAR Hypodense lesion with mural nodule, edema/enhancement rare. T1W-hypointense T2W-hyperintense COLLOIDAL VESICULAR Ring enhancing lesion with edema. Hyperintense on T2W with peripheral enhancement/edema. GRANULAR NODULAR Isodense cyst with hyperdense cacified scolex.Edema/enhanceme nt +. Isointense to hypointense on T2W.Target or Bull’s eye appearance. NODULAR CALCIFIED Small calcified nodule.No edema / enhancement. Void on T2W.
  18. 18. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 18
  19. 19. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 19 Calcified Granuloma
  20. 20. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 20 A CHILD PRESENTED WITH FEVER AND ALTERED SENSORIUM. A PROVISIONAL DIAGNOSIS OF ENCEPHALITIS WAS MADE. WHAT ARE CT FINDINGS
  21. 21. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 21 Herpes encephalitis
  22. 22. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 22 Japanese B Encephalitis
  23. 23. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 23 Meningo-Encephalitis
  24. 24. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 24 HOW DO YOU PROCEED WITH A SUSPECTED CASE OF INFARCT? WHAT WOULD BE THE INVESTIGATION OF CHOICE?
  25. 25. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 25 DENSE MCA
  26. 26. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 26 MCA ( 3 diff patients)
  27. 27. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 27 Acute Infarct
  28. 28. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 28 PROTEIN C DEF.
  29. 29. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 29 PROTEIN C DEF.
  30. 30. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 30 MOYA MOYA
  31. 31. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 31 Venous sinus thrombosis PLAIN CECT
  32. 32. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 32 Venous infarct
  33. 33. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 33 I.C.Bleed
  34. 34. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 34 INTRAPARENCHYMAL BLEED STAGES CT MRI ACUTE (De-oxy Hb) Hyperdense to brain parenchyma. T1- HYPERINTENSE T2- HYPOINTENSE SUBACUTE (MethHb) 1 to 6 weeks. Isodense with adjacent brain parenchyma. Peripheral enhancement. T1- HYPERINTENSE T2- HYPERINTENSE CHRONIC (Haemosiderin) Hypodense to adjacent parenchyma. Fluid –fluid level s/o rebleed. T1- HYPOINTENSE T2- MORE HYPOINTENSE
  35. 35. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 35 Encephalomalacia
  36. 36. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 36 Porencephalic Cyst
  37. 37. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 37 ONE AND A HALF YEAR OLD CHILD – A CASE OF CEREBRAL PALSY WITH SPASTIC QUADRIPARESIS, MICROCEPHALY AND NORMAL VISION, WHAT WOULD YOU EXPECT TO SEE IN NEUROIMAGING ?
  38. 38. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 38 HIE
  39. 39. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 39 Hypoxic ischaemic encephalopathy Perinatal insult
  40. 40. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 40 PVL Perinatal insult
  41. 41. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 41 GERMINAL MATRIX HAEMMORAGE IN A PRETERM INFANT
  42. 42. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 42 BASAL GANGLIA CALCIFICATION- AN INCIDENTAL FINDING. IS IT NORMAL OR ABNORMAL? WHAT CLUES ON NEUROIMAGING WOULD HELP?
  43. 43. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 43 Basal Ganglia Calcification
  44. 44. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 44 CAUSES OF BASAL GANGLIA CALCIFICATION COMMON Idiopathic Fahr’s Disease Hypoparathyroidism Postinflammatory ( TB, CID, toxoplasmosis, cysticercosis, congenital HIV ) UNCOMMON Congenital ( Tuberous sclerosis, Downs syndrome, MELAS/MERRF, Cockayne syndrome ) Post anoxic/toxic ( carbon monoxide poisoning, chemotherapy and radiation therapy)
  45. 45. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 45 TORCH(CMV)
  46. 46. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 46 TORCH(CMV)
  47. 47. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 47 WHICH ARE THE NEURODEGENERATIVE DISORDERS THAT SHOW POSITIVE NEUROIMAGING FINDINGS? HOW MANY CASES HAVE YOU SEEN SO FAR? WHAT ARE SPECIFIC OBSERVATIONS ON IMAGING?
  48. 48. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 48 Leukodystrophy
  49. 49. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 49
  50. 50. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 50 KEY POINTS  HEAD CIRCUMFERENCE  AGE OF ONSET  PATTERN OF INVOLVEMENT
  51. 51. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 51 Normal head circumference Central to peripheral pattern Metachromatic leukodystrophy (onset: 4 to 8 years) Krabbe's disease (onset: before 4 years) Pelizaeus-Merzbacher disease (onset: 4 to 8 years, boys) Dorsal to ventral pattern Adrenoleukodystrophy* (onset: 4 to 8 years) Increased head circumference Peripheral to central pattern Canavan's disease (onset: infancy) Ventral to dorsal pattern Alexander's disease* (onset: infancy) *Enhances with gadolinium.
  52. 52. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 52 DISTINCTIVE FEATURES OF LEUKODYSTROPHIES COMPLETE OR NEAR LACK OF MYELINATION Canavan Disease Pelizaeus-Merzbacher Disease FRONTAL WHITE MATTER MOST INVOLVED Alexander Disease OCCIPITAL WHITE MATTER MOST INVOLVED Adrenoleukodystrophy THICK MENINGES Hurler Syndrome
  53. 53. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 53 Adrenal Leukodystrophy
  54. 54. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 54 Alexander’s Disease
  55. 55. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 55 Canavan’s disease
  56. 56. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 56 LEUKODYSTROPHY
  57. 57. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 57 LEUKODYSTROPHY
  58. 58. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 58  Occurs in highly predictable orderly fashion.  Caudad to cephalad, dorsal to ventral and central to peripheral. NORMAL MYELINATION
  59. 59. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 59 Normal Myelination Pattern
  60. 60. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 60 BIRTH Medulla, Dorsal midbrain, Cerebellar peduncles, Posterior limb of internal capsule. ONE MONTH Deep cerebellar white matter, Corticospinal tracts, Pre/postcentral gyrus, optic nerves and tracts. THREE MONTHS Brachium pontis, ventral brainstem, optic radiations, anterior limb of internal capsule, corpus callosal splenium. SIX MONTHS Corpus callosum genu, paracentral subcortical U fibres, centrum semiovale. EIGHT MONTHS Centrum semiovale, Subcortical U fibres. EIGHTEEN MONTHS Essentially like adult.
  61. 61. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 61 Normal Myelination - Age 1 Day On T2-weighted images the white matter has a higher signal intensity than the gray matter except. Low–signal intensity myelin is seen in the ventrolateral thalamus, dorsal pons, and rolandic and perirolandic gyri.
  62. 62. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 62 Normal Myelination - Age 1 Month T2-weighted images show further deposition of myelin in the ventrolateral thalamus, posterior limb of the internal capsule, and rolandic and perirolandic gyri. Note the small amount of myelin in the optic radiations.
  63. 63. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 63 Normal Myelination - Age 3 Months On T2-weighted images, myelin deposition is seen throughout the posterior limb of the internal capsule and in the optic radiations and the white matter of the central semiovale adjacent to the precentral and postcentral gyri. The entire medulla and the central cerebellar white matter are now myelinated.
  64. 64. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 64 Normal Myelination - Age 13 Months On T2-weighted images the white matter now has a lower signal intensity than the gray matter (early adult pattern).
  65. 65. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 65 WHAT ARE THE VARIOUS NEURONAL MIGRATION ANOMALIES? WHAT MODALITY OF NEUROIMAGING WOULD YOU PREFER?
  66. 66. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 66 Neuronal migration anomalies Agyria/pachygyria
  67. 67. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 67 Agyria/pachygyria
  68. 68. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 68 Cortical Dysplasia
  69. 69. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 69 Polymicrogyria
  70. 70. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 70 Heterotopia
  71. 71. © 2003 By Default! A Free sample background from www.awesomebackgrounds.com Slide 71 Schizencephaly

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