neuroradiology - usmf...•chist hidatic cerebral angiography •catheter angiography:...
TRANSCRIPT
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NEURORADIOLOGY
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Imaging Modalities
• Conventional Radiography • Computed Tomography • Magnetic Resonance Imaging • Ultrasonography • Angiography • Scintigraphy, Positron Emission
Tomography, PET/CT
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Posteroanterior Skull Projection Is used for documentation of skull and facial skeletal asymmetries.
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Lateral Skull Projection Is used for documentation of skull and facial skeletal asymmetries.
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Axial Skull Projection As an initial radiograph to check the condylar axes, or as a supplement to a
panoramic radiograph for localization of extremely laterally impacted
maxillary third molars.
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Computed Tomography
• The X-ray tube emits a sharply collimated fan beam of X-rays
which passes the patient and reaches an array of detectors. Tube
rotates around the patient.
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Computed Tomography
• Spiral CT – X-ray tube rotates continuously around the
patient.
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Computed Tomography
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MAGNETIC RESONANCE IMAGING
(MRI)
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MRI
Uses magnetic fields and radio waves
to produce images of thin slices of
tissues (tomographic images).
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MRI • Normally, protons within tissues spin to produce tiny
magnetic fields that are randomly aligned.
• When surrounded by the strong magnetic field of an
MRI device, the magnetic axes align along that field.
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MRI • A radiofrequency pulse is then applied, causing the axes
of all protons to momentarily align against the field in a high-energy state.
• After the pulse, some protons relax and resume their baseline alignment within the magnetic field of the MRI device.
• The magnitude and rate of energy release that occurs as the protons resume this alignment (T1 relaxation) and as they wobble (presses) during the process (T2 relaxation) are recorded as spatially localized signal intensities by a coil (antenna).
• Computer algorithms analyze these signals and produce anatomic images.
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MRI
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Advantages of MR • No ionizing radiation
• High contrast resolution
• Good spatial resolution
• Multiplanar capabilities
• Requires little patient preparation and is noninvasive.
• Lack of artifacts from adjacent bones
• Multi weighted sequences:
– Fluid attenuation (FLAIR)
– Fat suppression (STIR)
– Diffusion weighted (DWI), Diffusion Tensor (DTI)
– Functional MR (fMR: BOLD)
– Spectroscopy (MRS)
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Normal MR Brain
T1 Weighted Image T2 Weighted Image
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Sagittal MR Brain
T1 WI
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• ANOMALII DE DEZVOLTARE
• TRAUMATISMUL CRANIOCEREBRAL
• ACCIDENTUL VASCULAR CEREBRAL
• PROCESE TUMORALE
• PROCESE INFECȚIOASE
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ANOMALII DE DEZVOLTARE
CHIARI I
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ANOMALII DE DEZVOLTARE
CHIARI III
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ANOMALII DE DEZVOLTARE
• AGENEZIA
CORPULUI
CALOS
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ANOMALII DE DEZVOLTARE
• LIPOM
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ANOMALII DE DEZVOLTARE
• MALFORMAȚIE DANDY
WALKER
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ANOMALII DE DEZVOLTARE
• HOLOPROSECEFAL
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ANOMALII DE DEZVOLTARE
• MICROCEFAL
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ANOMALII DE DEZVOLTARE
• HETEROTOPIA SUBSTANȚEI
CENUȘII
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TRAUMA
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Plain X-Ray
SKULL FRACTURE
Fracture
Line
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Extradural Hematoma
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TRAUMATISMUL
CRANIOCEREBRAL
• HEMATOM
EPIDURAL
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Subdural Hematoma
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TRAUMATISMUL
CRANIOCEREBRAL
• HEMATOM
SUBDURAL
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Subarachnoid Hemorrhage
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TRAUMATISMUL
CRANIOCEREBRAL
• HEMORAGIE
SUBARAHNOIDIA
NĂ
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TRAUMATISMUL
CRANIOCEREBRAL • CONTUZIE CEREBRALĂ
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Digital Image Soft Tissue Window Bone Window
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Brain Contusions
Hemorrhagic Contusions
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Brain Lacerations
Gunshot Injury
R
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AVC
• HEMORAGIE INTRACEREBRALĂ
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AVC
• HEMORAGIE
INTRACEREBELOASĂ
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Acute Middle Cerebral Infarct
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AVC
• AVC ISCHEMIC ÎN FAZA ACUTĂ
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AVC
• AVC ISCHEMIC CEREBELOS ÎN FAZA
ACUTĂ
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AVC • AVC ISCHEMIC ÎN FAZA
CRONICĂ
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PROCESE TUMORALE
• Astrocitom
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PROCESE TUMORALE
• Astrocitom fibrilar
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• Glioblastom
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Glioma
T1 WI T2 WI T1 WI Post-Contrast
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PROCESE TUMORALE • Oligodentrogliom
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Brain stem Glioma
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PROCESE TUMORALE
• Meningiom
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PROCESE TUMORALE
• Meningiom
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PROCESE TUMORALE
• Meningiom
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• Meningiom
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PROCESE TUMORALE
• Meningosarcom
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Pituitary Adenoma
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Acoustic Neurinoma
T1 WI T1 WI Post Contrast
MRI
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LEZIUNI NON-TUMORALE
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PROCESE INFECȚIOASE
• ENCEFALITĂ
HERPETICĂ
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Pyogenic Brain Abscess
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PROCESE INFECȚIOASE
• ABCES CEREBRAL
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PROCESE INFECȚIOASE
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PROCESE INFECȚIOASE
• MENINGITĂ TB
(postcontrast)
• TB
CEREBRALĂ
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PROCESE PARAZITARE
• NEUROCISTICERCOZĂ
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PROCESE PARAZITARE
• CHIST HIDATIC
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Cerebral Angiography
• Catheter Angiography: – Conventional
– Digital Subtraction
• Magnetic Resonance Angiography (MRA)
• Computed Tomography Angiography (CTA)
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Before After
Embolization of AVM
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MR Angiography
Anterior Communicating Artery
Aneurysm
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Middle Cerebral Artery Aneurysm
CT Angiography
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SPINE
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Anatomy
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Plain X-Ray
A-P view Lateral view Oblique view
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MYELOGRAPHY
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CT
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Degenerative Spondylolisthesis
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MRI
T1 WI T2 WI
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ANOMALII DE DEZVOLTARE
• CIFOZĂ
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T1w T2wir
Sagittal View
MRI
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ANOMALII DE DEZVOLTARE • HEMIVERTEBA
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ANOMALII DE DEZVOLTARE
• VERTEBRĂ
ÎN
FLUTURE
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ANOMALII DE DEZVOLTARE • BLOC
VERTEBRAL
• LIPOM
INTRADURAL
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ANOMALII DE DEZVOLTARE
• SIRINGOMIELIA
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ANOMALII DE DEZVOLTARE
• SCOLIOZĂ
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Traumatic Cord Contusion
T2 WI
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T1 WI T2 WI
Disc Herniation MRI
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Infective Spondylitis
T1WI T1WI Post Contrast
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PROCESE TUMORALE
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Glioma
T1 WI POST CONTRAST
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Meningioma
T1 WI POST CONTRAST
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Neurinoma
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MRI CT
Soft tissue Window
Bone Window
Metastases