Neuroradiology slideshare
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NEURORADIOLOGY _ IMAGING MODALITY
Simple Radiography Cheaper Accuracy is low
Only bone not the brain is visualized
NEURORADIOLOGY _ IMAGING MODALITY
CT Scan/ Computerized Tomography Magnetic Resonance Imaging CT Angiography Nuclear medicine__ PET, SPECT Ultrasound__ mainly for neonates INTERVENTIONAL RADIOLOGY
WHAT IS CT SCAN
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
WHEN IS CT PERFORMED
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
CONTD.
CT plays a critical role in the early screening of
diagnosis of many brain diseases in spine imaging and in orbital facial disease
ABSOLUTE CONTRAINDICATION
Avoid screening in pregnancy Allergy to contrast Renal impairment Hypothyrodism Phaeochromocytoma Myaesthenia gravis
ADVERSE EFFECT
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
CT SCAN COULD BE
Plain : NCCT Contrast: CECT contrast is not used in case of TRAUMA and CVA contrast goes to vascular and viable tissue
TRAUMA FRACTURE
TRAUMA EXTRADURAL
HEMATOMA
TRAUMA SUBDURAL
HEMATOMA
INFECTION__ PYREXIA
BRAIN ABSCESS
RAISED ICT __ HEADACHE
BRAIN MASS
CEREBROVASCULAR ACCIDENT
INFARCTION
CEREBROVASCULAR ACCIDENT
HAEMORRHAGE
PARASITIC INFECTION
NEUROCYSTICERCOSIS
RAISED ICT ON SHUNT
HYDROCEPHALUS
DEGENERATIVE BRAIN
ATROPHY
MAGNETIC RESONANCE IMAGING
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
CONTD.
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……
WHEN IS MRI PERFORMED
MRI is used extensively for the study of blood
vessel flow dynamics , 3D volume rendering and stereotactic surgical guidance
MRI FOR BRAIN Stroke Infection / Inflammation Tumour Multiple sclerosis Dementia Post trauma Metabolic disorder Congenital disorder Internal auditory canal pathology Nerve palsy Spinal cord lesion
MRI _ OTHER INDICATION
Abdomen/ Pelvis Musculoskeletal tissue Cardiac__ Ischaemia, Tumour ,Infiltrative
CCM Vascular study Obstetrics__ Fetal anomaly esp cerebral
anomaly no risk of radiation
ABSOLUTE CONTRAINDICATION
Pacemaker, metalic body, implant, aneurysmal repair etc
ADVERSE EFFECT
No known side effect
ADVANCED MRI TECHNIQUE
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
HAEMORRHAGE ON MRI
CEREBROVASCULAR ACCIDENT
SPINAL TRAUMA VERTEBRAL DISLOCATION
DISC PROLAPSE BACKACHE
ANGIOGRAPHY _ DSA 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
WHEN IS DSA PERFORMED
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
ANGIOGRAPHY RENAL
ANGIOGRAPHY CARDIAC
NUCLEAR MEDICINE
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
NUCLEAR MEDICINE
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
TYPE OF NUCLEAR MEDICINE
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
SPECT IN BRAIN
SINGLE PHOTON EMISSION TOMOGRAPHY
Mapping of Dopamine transport system in movement disorder like Parkinsonism
Specific tracer working at neuromuscular junction
POSITRON EMISSION TOMOGRAPHY
It is expensive
Positron tracer like carbon, nitrogen , oxygen are used for focal brain metabolism
Main use in ONCOLOGY
ISOTOPE SCAN THYROID
ISOTOPE SCAN BONE
SINGLE PHOTON EMISSION
TOMOGRAPHY SPECT
ULTRASOUND
Neonatal head for__Big head/Hydrocephalus Hypoxia Haemorrhage Birth trauma Subdural Haematoma Fits Congenital anomaly
NEONATAL BRAIN ON ULTRASOUND
HYDROCEPHALUS
INTERVENTIONAL RADIOLOGY
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
Thank you Have a nice day
Dr Rekha Khare