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Neuroradiology lecture3
- 1. Simple Radiography Cheaper Accuracy is low Only bone not the brain is visualized
- 2. CT Scan/ Computerized Tomography Magnetic Resonance Imaging CT Angiography Nuclear medicine__ PET, SPECT Ultrasound__ mainly for neonates INTERVENTIONAL RADIOLOGY
- 3. CT imaging uses X-rays to produce cross sectional images/slices of the brain. As x-rays pass through the body they are absorbed or attenuated differently. These varying attenuation value / CT value give information on normal and abnormal structure in the brain and spine producing an image
- 4. CT Scanner is work horse of neuroimaging and is the imaging method of choice .Trauma . Cerebro- vascular accidents .Epilepsy/ Fit/ Seizure . Altered consciousness . Pyrexia of unknown origin .Intracranial mass/ Raised ICT
- 5. CT plays a critical role in the early screening of diagnosis of many brain diseases in spine imaging and in orbital facial disease
- 6. Avoid screening in pregnancy Allergy to contrast Renal impairment Hypothyrodism Phaeochromocytoma Myaesthenia gravis
- 7. Radiation dose Reaction to Contrast eg. Average effective dose chest x-ray is about 20mSV, brain CT 2200mSV which is close to amount of back ground radiation that an average person receives in a year from atmosphere even if they don’t have any diagnostic imaging of any kind 2400mSV
- 8. This exposure can be from an external source irradiating the whole body, an extremity, or other organ or tissue resulting in an external radiation dose. Alternately, internally deposited radioactive material may cause aninternal radiation dose to the whole body, an organ, or a tissue. Smaller fractions of these measured quantities often have a prefix, such as milli (m) that means 1/1,000. For example, 1 sievert = 1,000 mSv. Micro (μ) means 1/1,000,000. So, 1,000,000 μSv = 1 Sv, or 10 μSv = 0.000010 Sv. Conversions from the SI units to older units are as follows: 1 Gy = 100 rad 1 mGy = 100 mrad 1 Sv = 100 rem 1 mSv = 100 mrem
- 9. Plain : NCCT Contrast: CECT contrast is not used in case of TRAUMA and CVA contrast goes to vascular and viable tissue
- 10. FRACTURE
- 13. BRAIN ABSCESS
- 14. BRAIN MASS
- 15. INFARCTION
- 16. HAEMORRHAGE
- 18. HYDROCEPHALUS
- 19. ATROPHY
- 20. MRI uses a strong magnetic field ( not x-ray) to create images of the body Radiofrequency pulse(RF) are generated to interrogate the hydrogen atoms that make up the human body Powerful computer process the returning RF signal to form medical images As a rule MRI produces high resolution images in multiple planes
- 21. Depending on the coils and pulse sequence selected MRI examination can be tailored to yield the desired diagnostic information Pulse sequence: T1, T2,DW, STIR, etc……
- 22. MRI is used extensively for the study of blood vessel flow dynamics , 3D volume rendering and stereotactic surgical guidance
- 23. Stroke Infection / Inflammation Tumour Multiple sclerosis Dementia Post trauma Metabolic disorder Congenital disorder Internal auditory canal pathology Nerve palsy Spinal cord lesion
- 24. Abdomen/ Pelvis Musculoskeletal tissue Cardiac__ Ischaemia, Tumour ,Infiltrative CCM Vascular study Obstetrics__ Fetal anomaly esp cerebral anomaly no risk of radiation
- 25. Pacemaker, metalic body, implant, aneurysmal repair etc
- 26. No known side effect
- 27. Research make use of cutting edge technologies to visualize not only anatomical images but also early changes that occur in brain function before there is any visible abnormality in structural imaging eg. Functional MRI include diffusion perfusion and task activation research pulse sequence
- 30. BACKACHE
- 31. DIGITAL SUBSTRACTION ANGIOGRAPHY It uses X-rays and injected contrast media to demonstrate the arteries and vein in real time . It is NEUROANGIOGRAPHY when technique is applied to the vessel in brain To see the blood vessel clearer DSA uses computers to remove / substract bone and other structures so that blood vessels stand out
- 32. To study the architecture of blood vessels Detecting and diagnosing vascular anomaly Bleeding in brain and spinal cord Narrowing / spasm of blood vessel Stroke /Paralysis/ Hemiplegia Mass
- 33. RENAL
- 34. CARDIAC
- 35. Nuclear Medicine uses very small amount of radioactive material called Radiopharmaceuticals Isotopes are specific for the part, injected or given orally Isotopes are distributed throughout the blood stream and are attracted to specific organs/ tissue
- 36. Isotope in the tissue emit gamma radiation which is detected and counted by gamma camera The processed data over time provides functional and anatomical information about the part being imaged
- 37. BRAIN SPECT__ single photon emission tomography for cerebral ischaemia, epilepsy MIBI HEART PERFUSION SCAN__For Ischaemic heart disease BONE SCAN__ For cancer, stress Fracture THYROID UPTAKE SCAN__ For Thyroid nodule V/Q SCAN__ For Pulmonary embolism
- 38. SINGLE PHOTON EMISSION TOMOGRAPHY Mapping of Dopamine transport system in movement disorder like Parkinsonism Specific tracer working at neuromuscular junction
- 39. It is expensive Positron tracer like carbon, nitrogen , oxygen are used for focal brain metabolism Main use in ONCOLOGY
- 40. THYROID
- 41. BONE
- 42. SPECT
- 43. Neonatal head for__Big head/Hydrocephalus Hypoxia Haemorrhage Birth trauma Subdural Haematoma Fits Congenital anomaly
- 44. HYDROCEPHALUS
- 45. It is the technique used to treat blood vessel disease, tumour , clot/ thrombus etc in the brain and spinal canal Procedure is like angiography and then pushing the therapeutic agent like Thrombolytic agent in case of Infarction
- 46. Dr Rekha Khare MD Radiology