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Neuro Unit 2 Neuroimaging
Neuroimaging
103
Other
Graduate
03/03/2011
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Term
X-Rays (plain films)
 Definition
This is the oldest radiographic technique used to visualize bony and soft tissue structures of the head.
Term
black/white
 Definition
X-ray radiation that strikes the film exposes it turning it black or white? Dense structures shield the x-ray beam thus most dense structures (bones/teeth) appear what color.
Term
True
 Definition
True/False: Because the x-ray technique can be performed very rapidly, it still has some use when diagnosing a skull fracture or diseases of the calvariam.
Term
1) Exposure to x-rays
2) Very poor visualization of soft tissues
 Definition
Name 2 contraindications to x-rays
Term
2D representation of a 3D object.
 Definition
Name the limitation to x-rays
Term
1) Delineation of Fractures
2) Localization of Foreign Bodies
3) Detection of pneumocephalus
 Definition
Name 3 uses of X-rays for Trauma
Term
1) Displacement of physiological calcifications
2) Observation of abnormal calcifications
3) Demonstration of increased cranial pressure
4) Erosion of bone
 Definition
Name 4 uses of X-rays in the evaluation of intracranial masses
Term
1) Generalized Diseases
2) Localized lesions
3) Metastasis, primary bone tumors
 Definition
Name 3 uses of X-rays in evaluating calvarial diseases
Term
Tomography
 Definition
? is a thin section radiograph produced by creating a thin focus plane
Term
Tomography/opposite
 Definition
? is accomplished by moving x-ray tube and film cassette simultaneously in the same OR opposite directions.
Term
thinner the cut
 Definition
In Tomography, the further the travel the thicker or thinner the cut?
Term
Tomography
 Definition
? blurs out overlying shadows allowing precise analysis of roentgen observation.
Term
1) Internal Auditory Canals
2) Optic Foramina
3) Sella Turcica
4) Skull base
5) Spine
 Definition
Name 5 uses of Tomography
Term
1970s/Computed Tomography
 Definition
CT Scans were introduced into clinical practice in (name the year?). CT stands for ?
Term
x-rays
 Definition
CT uses ? to visualize hard and soft tissue.
Term
CT
 Definition
Unlike a plain film x-ray, ? uses computers to reassemble the image into a series of thin, 5-10 mm, 2D slices of the patient.
Term
light/dark
 Definition
in CT, structures that attenuate x-rays (bone) appear light or dark and areas that are filled with air or CSF appear light or dark since these substances do not block x-rays.
Term
white/black
 Definition
In CT, bone is always ? while CSF are what color.
Term
CT
 Definition
If a head trauma patient enters the ER is a CT or MRI preferred if it must be done quickly!
Term
can/quickly
 Definition
In a CT scan skull fractures can or cannot be revealed and the presence of an epidural or subdural hematoma can be assessed quickly or slowly.
Term
radio-opaque contrast material
 Definition
Since CT scans use x-rays, ? can be used to reveal the vasculature.
Term
can
 Definition
In a CT scan, Contrast material can or cannot reveal where the blood-brain-barrier has broken down within the CNS.
Term
circumventricular
 Definition
With the exception of ? organs, the blood-brain-barrier (BBB) is present in all regions of the CNS.
Term
Abscess
 Definition
With a CT Scan, an ? in the CNS will appear as a dark structure surrounded by a bright ring ("ring enhancement").
Term
Blood Brain Barrier (BBB)
 Definition
In a CT scan, an abscess represents the region where the ? has broken down and allowed contrast material to leak out of the vasculature.
Term
1) Localization of intra- and extracerebral hematomas
2) Identification of cerebral edema
3) Observation of cerebral contusions
4) Identification of skull fractures
 Definition
Name 4 uses of a CT Scan in regards to trauma.
Term
Arteriovenous malformations and aneurysms
 Definition
Name 2 vascular lesions that a CT Scan might be used to identify.
Term
1) Benign/Malignant tumors
2) Intracerebral hematomas
 Definition
Name 2 intracranial mass lesions that a CT scan might be used to localize.
Term
1) Hydrocephalus
2) Pseudotumor cerebri
 Definition
A CT Scan might be used to determine ventricular size in ? and ?
Term
CT Scan
 Definition
Which Neuroimaging method would be best to determine ventricular size in hydrocephalus or pseudotumor cerebri.
Term
CT Scan
 Definition
Which neuroimaging device would be best to identify vascular lesions like Aneurysms or Arteriovenous malformations.
Term
CT Scan
 Definition
Which neuroimaging method would be best to localize an intracranial mass lesion like a benign/malignant tumor or an intracerebral hematoma.
Term
Cerebral Angiography
 Definition
This neuroimaging technique is used to identify aneurysms, vascular tumors and non-vascular tumors.
Term
Cerebral Angiography
 Definition
In this neuroimaging method an iodinated contrast material is injected via a catheter in the femoral a., into the common carotid or vertebral aa.
Term
Cerebral Angiography
 Definition
In this neuroimaging technique, x-rays are used to visualize the arteries filled with a contrast material.
Term
arterial, capillary and venous phases
 Definition
In Cerebral Angiography, a series of x-rays are rapidly shot so that the ?, ? and ? phases of the brain vasculature can be visualized.
Term
intracranial lesions
 Definition
Normal vascular patterns are fairly consisten; deviations from the normal patterns suggest the presence of ? that diminish or enhance blood flow or shift the position of the blood vessels.
Term
No
 Definition
In a Cerebral Angiography are neural structures imaged with this technique. (Yes or no)
Term
Magnetic Resonance Angiography (MRA)
 Definition
Cerebral Angiography is being replaced by ?
Term
surgical/contrast material
 Definition
MRA is far more expensive than cerebral angiography but MRA avoids the ? risk involved in the catheterization used to inject ?.
Term
Cerebral Angiography
 Definition
This neuroimaging technique precisely identifies surgical lesions like the neck of the aneurysm and tumor mapping.
Term
Atherosclerosis and Metabolic diseases
 Definition
Cerebral Angiography is used to evaluate generalized vascular diseases like ? and ?
Term
Pseudoaneurysms and Arteriovenous fistulae
 Definition
Cerebral Angiography is used to identify vascular traumatic lesions like ? and ?
Term
Cerebral Angiography
 Definition
Which neuroimaging method is used to identify vascular traumatic lesions like Pseudoaneurysms and Arteriovenous fistulae.
Term
Cerebral Angiography
 Definition
Which neuroimaging method is used to evaluate generalized vascular diseases like Atherosclerosis and Metabolic diseases.
Term
Cerebral Angiography
 Definition
Which neuroimaging method is used in precise identification of surgical lesion like the neck of the aneurysm and tumor mapping.
Term
CT scan
 Definition
The ? is viewed as if looking from the feet of the patient upward.
Term
right
 Definition
When viewing a CT Scan the left side of the image is the right or left side of the patient and vice versa.
Term
axial
 Definition
In a CT scan, images are formed only in the ? plane.
Term
Exposure to x-rays and the contrast material b/c of some of the problems it may cause the patient.
 Definition
Name 2 contraindications to CT scans.
Term
1) Exposure to x rays
2) Surgical risk
3) adverse reaction to contrast medium
 Definition
Name the 3 contraindications to Cerebral Angiography
Term
a 2D representation of a 3D object.
 Definition
The limitation to the Cerebral Angiography method is ?
Term
Myelography
 Definition
This neuroimaging method is performed to image the spinal cord and nerve roots.
Term
spinal cord and nerve roots
 Definition
Myelography is used to image ? and ?
Term
Myelography
 Definition
In this neuroimaging method, the subarachnoid space is entered by lumbar puncture or by lateral cervical punture.
Term
CT and MRI
 Definition
In addition to Myelography, name two neuroimaging techniques that are alternates for diagnosis of some abnormalities of spinal cord and nerve roots.
Term
spinal canal/x-ray film
 Definition
In Myelography, the patient lies on a table that can be tilted to cause dye to move up and down the ? so that permanent images are record on ?
Term
1) Determine spinal cord lesion
2) Evaluation of relationship between the spinal canal and bony spine
3) diagnosis of herniated disc disease
 Definition
Myelography is used to determine lesions of the ?, evaluate the relationship between the ? and ? and diagnosis ? disease.
Term
Myelography
 Definition
Which Neuroimaging method is used to Determine a spinal cord lesion, Evaluate the relationship between the spinal canal and bony spine and for diagnosis of herniated disc disease
Term
MRI
 Definition
This technique uses a powerful magnetic field, as well as radiowaves and an antenna to image tissue.
Term
Magnetic Resonance Imaging
 Definition
MRI stands for ?
Term
Time 1 (T1) or Time 2 (T2)
 Definition
The time it takes for magnetic resonance energy to be released varies with each element as well as with time called ? or ? 'weighted' images.
Term
T1
 Definition
In a ? MRI image bone and CSF appear dark while fat is white. CNS white matter is lighter than gray matter.
Term
does not image
 Definition
In a CT scan fat does OR does not image?
Term
bright
 Definition
Fat gives a bright or dark signal in a MRI.
Term
does not
 Definition
In the usual MRI, bone is devoid of signal and does or does not image.
Term
True
 Definition
True/False: In a CT scan, bone has a very bright signal.
Term
T2-weighted MRI
 Definition
In a ? MRI, CSF and fat are white, while air and dense bone are dark.
Term
dark
 Definition
In a T2 MRI, flowing blood and CNS white matter both appear light or dark?
Term
ventricles/globes of the eyes. (Remember T2 = WWII like world war II and so WW water is white)
 Definition
The best way to determine if the MRI is a T1 or T2 is to examine the ? and/or the ? if they are white, then it is a T2.
Term
T2
 Definition
T? weighted MRI images are used to locate and describe pathology.
Term
T1
 Definition
T? weighted MRI images are used to display the normal anatomy of white vs. gray matter.
Term
True
 Definition
True/False: sometimes the contrast of the T-2 weighted MRI image is reversed.
Term
axially, coronally or sagittally
 Definition
Whereas CT images are restricted to the axial plane, MRIs can be ?, ? or ? reconstructed.
Term
Coronal, AP (anterior to posterior)
 Definition
MRI ? scans are viewed as though you are looking at the patient in the face so the slices run AP or PA?
Term
Axial
 Definition
? MRI scans are viewed as though you are standing at the patient's feet looking towards their head while the patient lies on their back in the machine.
Term
ventral to dorsal
 Definition
Axial MRI scans show the cerebral hemispheres from ventral to dorsal OR dorsal to ventral with the patient's orbits at the top and the occiput at the bottom
Term
right
 Definition
In both coronal and axial views, the patient's left side is to the observer's left or right side.
Term
Gadolinium
 Definition
This contrast material is used in MRIs to show the vasculature as well as the breakdown of the BBB around tumors or abscesses
Term
MR Angiography (MRA)
 Definition
When vasculature is being visualized with MRI it is called ?
Term
contrast material
 Definition
One advantage of an MRA is that it doesn't use ? but the resolution of the image is not yet as good as plain film angiography
Term
the plain film angiography
 Definition
Is the resolution of an image better in an MRA or a plain film angiography.
Term
MRI
 Definition
? is the superior imaging technique for the CNS
Term
1mm2 (1 mm squared)
 Definition
The magnets and computer programs in MRIs are now so powerful that objects ? in size can be visualized.
Term
1) joint prosthesis after 8 weeks
2) aortic aneurysm clips after 8 weeks
3) bowel staples after 8 weeks
 Definition
Name 3 safe devices a patient may have that can subjected to MRI scanning (are safe for it)
Term
No - too slow!
 Definition
Is an MRI the first choice for ER eval of a head trauma?
Term
No
 Definition
Can a person with a pacemaker receive an MRI?
Term
NO - not safe
 Definition
Are these devices safe or not safe for an MRI: cerebral aneurysm clips, epicardial pacing wires, some cochlear/ossicle implants, endovascular shunts.
Term
FALSE. Expense is a contraindication
 Definition
True/False: Expense is not a contraindication for a MRI.
Term
False. Thought processes can be 'seen' on the fMRI.
 Definition
True/False: The use of the fMRI to examine CNS activity is restricted to motor tasks. (you can't see the activity of someone's thoughts)
Term
Functional MRI (fMRI)
 Definition
Name the imaging technique where magnets are used to examine the CNS metabolic activity during a particular task.
Term
blood flow/hemoglobin
 Definition
The assumption with an fMRI is that a metabolically active region of the CNS will have increased ? with more O2 extracted from the ? than regions of the CNS not metabolically active.
Term
fMRI
 Definition
This imaging technique is revolutionizing the understanding of which CNS regions function when performing various motor and thought processes.
Term
PET (Positron Emission Tomography)
 Definition
In this imaging technique, gamma rays are detected with a scanner that portrays the distribution of the radionuclide through the brain.
Term
fMRI, PET and SPECT
 Definition
Name 3 Physiologic Imaging techniques.
Term
PET
 Definition
? is most commonly used imaging technique to display images of local metabolic rate for glucose throughout the brain.
Term
glucose
 Definition
PET is most commonly used to display images of local metabolic rate for ? throughout the brain.
Term
PET
 Definition
? can be used to evaluate cerebral blood flow, oxygen metabolism, and neurotransmitter receptor density.
Term
PET
 Definition
? may prove most useful for diagnosis of degenerative conditions such as Alzheimer's.
Term
injected intravenously
 Definition
How is the nuclide containing radiopharmaceuticals put into the patient for a PET scan.
Term
PET
 Definition
Of the 2 which provides more detail: PET or SPECT
Term
SPECT
 Definition
Of the 2 which is less expensive and more widely available: PET or SPECT
Term
SPECT
 Definition
Of the 2 in which are the available nuclides of less biological interest.
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