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Lecture Outline  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Sagittal Axial
 
CT/ CAT scanning: Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CT/ CAT scanning: Methodology ,[object Object],[object Object],[object Object],[object Object],[object Object],Basically, a narrow beam of X ray scans across a patient in synchrony with a radiation detector on the opposite side of the patient. CT scan  Showing a  brain tumor
CT/ CAT scanning: Tomographic images ,[object Object],[object Object],[object Object],[object Object]
 
What is a MRI? MRI stands for  magnetic resonance imaging. A MRI scanner has a magnetic field that is frequently up to  60,000  times as strong as Earth’s magnetic field! MRI equipment is expensive. 1.5 tesla scanners often cost between $1 million and $1.5 million USD. 3.0 tesla scanners often cost between $2 million and $2.3 million USD. Construction of MRI suites can cost up to $500,000 USD, or more, depending on project scope. Dangers of MRI's Video:  http://www.youtube.com/watch?v=_lBxYtkh4ts
MRI How does it work? The Basics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Molecules with magnetic charges align with the strong magnetic field. A radio frequency is used to tip these molecules over.
MRI How the image is made ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Magnetic Resonance Imaging (MRI) image of the brain
MRI:Advantages ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],CT vs MRI
MRI the disadvantages ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Material to read latter- Before MRI, there is a checklist! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Material to read latter-MRI Further checklist! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of MRI images ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of MRI images: T1- T2-weighted ,[object Object]
Pooley, R. A. Radiographics 2005;25:1087-1099 T1-weighted contrast In the brain  T 1 -weighted scans provide good gray matter/white matter contrast , in other words put simply,  T1 Weighted Images highlights fat deposition. Types of MRI images: T1WI
Pooley, R. A. Radiographics 2005;25:1087-1099 T2-weighted contrast Types of MRI images: T2WI T2 images are particularly well suited to edema as they are sensitive to water content (edema is characterized by increased water content). In other words, put more simply,  T2 weighted images light up liquid on the images being visualized .
Magnetic Resonance Angiography (MRA)  is a group of techniques based on Magnetic Resonance Imaging (MRI) to image blood vessels . MRA  generates pictures of the arteries to evaluate them for  stenosis  (abnormal narrowing) or  aneurysms  (vessel wall dilatations, at risk of rupture). A variety of techniques can be used to generate the pictures, such as administration of a paramagnetic contrast agent ( gadolinium, Gd ). Types of MRI images: Magnetic resonance angiography (MRA) Magnetic Resonance Angiography: Maximum intensity projection of an MRA covering from the top of the heart to just below the circle of Willis MRA showing the circle of Willis in the brain.
Material to read latter-T 1  vs T 2  MRI: Tissue Appearance WT FAT H2O MUSC LIG BONE T1 B D I D D Proton  Density I I I D D T2 I B I D D
Material to read latter-T 1  vs T 2  MRI: Tissue Appearance
Spine imaging ,[object Object],[object Object],[object Object],[object Object]
 
Functional Magnetic Resonance Imaging (fMRI)  ,[object Object],[object Object],[object Object],fMRI scan of the brain. The red areas are the ones showing the highest level of brain activity
 
Electroencephalograph (EEG) ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Material to read latter-Magnetoencephalograph (MEG) ,[object Object]
 
PET ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Wilson’s disease Das SK and Ray K (2006) Wilson's disease: an update Nat Clin Pract  Neurol   2: 482 – 493 10.1038/ncpneuro0291 Hyperintensities   due to copper  deposition in the bilateral basal ganglia and thalami shown by T2-weighted MRI of the brain
Radiology:  Glioblastoma is usually seen as a  grossly heterogeneous mass . R ing enhancement surrounding a necrotic center  is the most common presentation, but there may be multiple rings. Characterized by  irregular ring-enhancement surrounding a central non-enhancing region of necrosis . Note the shaggy inner-margin of the ring, and the remarkable variation in its thickness. The small foci of internal enhancement represent islands of  living tumor within the regions of necrosis .  Surrounding vasogenic edema  can be impressive, and adds significantly to the mass effect.  Glioblastoma multiforme ( GBM) Axial Gd Enhanced T1W MRI Axial T2W MRI
MRI appearance two months after whole brain radiation (small lesions gone and large lesion much smaller) Metastatic brain tumors
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Basic Features of  Brain Lesions  Mass effect
 
Multiple sclerosis (MS) Axial Gd Enhanced T1W MR Axial T2W MR MRI imaging of the brain Gd enhanced helps diagnose MS. Typical MS white matter lesions are bright lesions on T2-weighted image (left image), especially in the corpus callosum and periventricular regions. T2W axial T2W sagittal
Exam prep-what to know! ,[object Object],[object Object]
Neuroimaging Lecture

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Neuroimaging Lecture

  • 1.  
  • 2.
  • 3.  
  • 4.
  • 5.
  • 6.
  • 7.  
  • 8. What is a MRI? MRI stands for magnetic resonance imaging. A MRI scanner has a magnetic field that is frequently up to 60,000 times as strong as Earth’s magnetic field! MRI equipment is expensive. 1.5 tesla scanners often cost between $1 million and $1.5 million USD. 3.0 tesla scanners often cost between $2 million and $2.3 million USD. Construction of MRI suites can cost up to $500,000 USD, or more, depending on project scope. Dangers of MRI's Video: http://www.youtube.com/watch?v=_lBxYtkh4ts
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. Pooley, R. A. Radiographics 2005;25:1087-1099 T1-weighted contrast In the brain T 1 -weighted scans provide good gray matter/white matter contrast , in other words put simply, T1 Weighted Images highlights fat deposition. Types of MRI images: T1WI
  • 18. Pooley, R. A. Radiographics 2005;25:1087-1099 T2-weighted contrast Types of MRI images: T2WI T2 images are particularly well suited to edema as they are sensitive to water content (edema is characterized by increased water content). In other words, put more simply, T2 weighted images light up liquid on the images being visualized .
  • 19. Magnetic Resonance Angiography (MRA) is a group of techniques based on Magnetic Resonance Imaging (MRI) to image blood vessels . MRA generates pictures of the arteries to evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall dilatations, at risk of rupture). A variety of techniques can be used to generate the pictures, such as administration of a paramagnetic contrast agent ( gadolinium, Gd ). Types of MRI images: Magnetic resonance angiography (MRA) Magnetic Resonance Angiography: Maximum intensity projection of an MRA covering from the top of the heart to just below the circle of Willis MRA showing the circle of Willis in the brain.
  • 20. Material to read latter-T 1 vs T 2 MRI: Tissue Appearance WT FAT H2O MUSC LIG BONE T1 B D I D D Proton Density I I I D D T2 I B I D D
  • 21. Material to read latter-T 1 vs T 2 MRI: Tissue Appearance
  • 22.
  • 23.  
  • 24.
  • 25.  
  • 26.
  • 27.  
  • 28.
  • 29.  
  • 30.
  • 31.  
  • 32. Wilson’s disease Das SK and Ray K (2006) Wilson's disease: an update Nat Clin Pract Neurol 2: 482 – 493 10.1038/ncpneuro0291 Hyperintensities due to copper deposition in the bilateral basal ganglia and thalami shown by T2-weighted MRI of the brain
  • 33. Radiology: Glioblastoma is usually seen as a grossly heterogeneous mass . R ing enhancement surrounding a necrotic center is the most common presentation, but there may be multiple rings. Characterized by irregular ring-enhancement surrounding a central non-enhancing region of necrosis . Note the shaggy inner-margin of the ring, and the remarkable variation in its thickness. The small foci of internal enhancement represent islands of living tumor within the regions of necrosis . Surrounding vasogenic edema can be impressive, and adds significantly to the mass effect. Glioblastoma multiforme ( GBM) Axial Gd Enhanced T1W MRI Axial T2W MRI
  • 34. MRI appearance two months after whole brain radiation (small lesions gone and large lesion much smaller) Metastatic brain tumors
  • 35.
  • 36.  
  • 37. Multiple sclerosis (MS) Axial Gd Enhanced T1W MR Axial T2W MR MRI imaging of the brain Gd enhanced helps diagnose MS. Typical MS white matter lesions are bright lesions on T2-weighted image (left image), especially in the corpus callosum and periventricular regions. T2W axial T2W sagittal
  • 38.

Editor's Notes

  1. Figure MRI of childs head
  2. Figure Left CT scan showing intracranial tumor
  3. Axial plane CT vs MRI of brain tumor, same subject-mri clearly has better contrast resolution.
  4. Dystonia caused by defect in copper excretion
  5. WHO Grade IV Cell of Origin: ASTROCYTE Synonyms: GBM, glioblastoma multiforme, spongioblastoma multiforme Common Locations: cerebral hemispheres, occasionally elsewhere (brainstem, cerebellum, cord) Demographics: peak from 45-60 years Histology: grossly heterogeneous, degeneration, necrosis and hemorrhage are common Special Stains: GFAP varies, often present in areas of better differentiation Progression : Can't get any worse. Radiology: Glioblastoma is usually seen as a grossly heterogeneous mass. Ring enhancement surrounding a necrotic center is the most common presentation, but there may be multiple rings. Surrounding vasogenic edema can be impressive, and adds significantly to the mass effect. Signs of recent (methemoglobin) and remote (hemosiderin) hemorrhage are common. Despite it’s apparent demarcation on enhanced scans, the lesion may diffusely infiltrate into the brain, crossing the corpus callosum in 50-75% of cases.