CNS Imaging. Dr Amir Monir, MD. Lecturer of radiodiagnosis.
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1 CNS Imaging Dr Amir Monir, MD Lecturer of radiodiagnosis
2 Types of radiological examinations you know
3 Plain X ray X ray with contrast GIT : barium (swallow, meal, follow through, enema) ERCP UT : IVP, cystogram Genital : HSG Respiratory : Bronchography CNS : Myelography Skeletal : Arthrography Ultrasonography ( NOT on skull or chest ) Doppler US CT MRI Isotope scan Interventional (Angiography)
4 Methods of CNS imaging Plain X ray CT MRI Others: myelography
5 Methods of CNS imaging Plain X ray. AP view : detection of cervical ribs. Lateral view shows : Cx Spine Curve of the spine. Intervertebral disc spaces. Spondylotic changes. Vertebral compression.
6 Methods of CNS imaging Spine MRI Disc prolapse. Bone marrow infilteration. Spinal cord lesions: astrocytoma, syringohydrmyelia. Nerve sheath tumors: schwanoma. Spinal infection. Degenerative changes.
7 CT The idea X ray!!
8 CT Computerized =we use computer to produce images Tomography =we slice the patient
9 Some funny stuff CT.the mummy
10 CT basic concepts It uses X rays to produce cross sectional images Types : 1 Conventional 2 Contrast enhanced : evaluation of vessels ( normal / abnormal ). evaluation of lesions ( inflammatory / neoplastic ) 3 Spiral, Helical CT : very fast 3D applications 4 Multislice CT : uses multiple rows of detectors 5 SPECT (Single Photon Emission CT) : uses isotopes 6 Electron beam
11 CT basic concepts Techniques : 1 CT angiography 2 CT Urography 3 CT virtual colonoscopy 4 CT virtual bronchoccopy
12 CT Terms Axial (whole body), Coronal ( brain, PNSs ), NO Sagittal CT
13 Terms Planes
14 CT Terms Density : hypodense ( dark ), hyperdense ( bright ) Bone Water Window: Bone window Pulmonary window Mediastinal window Fat Air
15 MRI NO X rays Use magnetic fields to produce images Many advantages Highest quality ever Multiplanar No radiation Many applications Few disadvantages cost availability certain precautions
16 MRI Open MRI
17 MRI basic concepts Many similarities with CT Techniques : 1 MR Angiography 2 MR Urography 3 MRCP ( Cholangio pancreatography ) 4 MR Myelography 5 Functional imaging : Spectroscopy Diffusion Perfusion BOLD (Blood Oxygen Level Dependent)
18 MRI basic concepts Differs from CT Intensity : hypointense ( dark ), hyperintense ( bright ) Fluid Fat Sequence : T1 hypo hyper T2 hyper hypo T1 T 2
19 Brain anatomy
20 A. Orbit B. Sphenoid Sinus C. Temporal Lobe D. External Auditory Canal E. Mastoid Air Cells F. Cerebellar Hemisphere
21 A. Frontal Lobe B. Frontal Bone (Superior Surface of Orbital Part) C. Dorsum Sellae D. Basilar Artery E. Temporal Lobe F. Mastoid Air Cells G. Cerebellar Hemisphere
22 A. Frontal Lobe B. Sylvian Fissure C. Temporal Lobe D. Suprasellar Cistern E. Midbrain F. Fourth Ventricle G. Cerebellar Hemisphere
23 A. Falx Cerebri B. Frontal Lobe C. Anterior Horn of Lateral Ventricle D. Third Ventricle E. Quadrigeminal Cistern F. Cerebellum
24 A. Anterior Horn of the Lateral Ventricle B. Caudate Nucleus C. Anterior Limb of the Internal Capsule D. Putamen and Globus Pallidus E. Posterior Limb of the Internal Capsule F. Third Ventricle G. Quadrigeminal Plate Cistern H. Cerebellar Vermis I. Occipital Lobe
25 A. Genu of the Corpus Callosum B. Anterior Horn of the Lateral Ventricle C. Internal Capsule D. Thalamus E. Pineal Gland F. Choroid Plexus G. Straight Sinus
26 A. Falx Cerebri B. Frontal Lobe C. Body of the Lateral Ventricle D. Splenium of the Corpus Callosum E. Parietal Lobe F. Occipital Lobe G. Superior Sagittal Sinus
27 A. Falx Cerebri B. Sulcus C. Gyrus D. Superior Sagittal Sinus
28
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