528 Introduction to Neural Imaging

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Imaging orientation axial (horizontal)

looking as though from the patient's feet

imaging orientation side left and right

coronal-displayed as though you are looking the patient in the face

what can be highlighted in a computerized tomography

ventricular and cisternal system

bone, acute blood CT color

very white

enhanced tumor CT color

very white

What shows up as light gray in a CT scan

subacute blood, muscle, grey matter

What shows up as medium grey in a CT scan

white matter

shows up as medium grey to black on the CT scan

CSF

shows up as black on the CT scan

air and fat

what are teh benefits of computerized tomography

fast, cost effective, clearly shows, sacute and subacute hemorrhages in the menigial spaces, show clear skull fractures

what are the cons of a computerizes tomography

Does not clearly show acute or sub acute infarcts, ischemia or brain edema
Does not clearly differentiate white from grey matter as well as MRI
Gives exposure to ionizing radiation

Basic properties of an MRI

induces magnetic resonace of protons in strong magnetic fields
produces images of the CNS in sections
differentiation of gray and white matter
can create 3D images

T2- MRI

resonance of protons whose fields were enhanced by a radiofrequency pulse (fast resonance)

T1-MRI

T1- resonance of protons whose fields were cancelled by a radiofrequency pulse (slow resonance)

T1-MRI normal structure colors

bone-very black
air-very black
muscles-dark grey
white matter-light grey
grey matter-dark grey
fat-white
CSF-very black

T2-MRI normal structure colors

bone-very black
air-very black
muscles-dark grey
white matter-dark grey
grey matter-light grey
fat-grey
CSF-very white

T1-MRI abnormal structure colors

edema-dark grey
tumor- variable
enhanced tumor-white
acute infarct-dark grey
subacute infarct-dark grey
acute ischemaia-dark grey
subacute ischemia-dark grey

T2-MRI abnormal structure colors

edema-light grey to white
tumor- variable
enhanced tumor-rarely done
acute infarct-light grey to white
subacute infarct-light grey to white
acute ischemaia-light grey to white
subacute ischemia-light grey to white

what are the benefits of an MRI

Can be manipulated to visualize a wide viariety of abnormailities or abnormal states within the brain
Can show great detail of the brain in normal and abnormal states.

what are the cons of an MRI

Doesn't show acute or subacute subarachnoid hemorrhage or hemorrhage into the substance of the brain in any detail.
Takes a much longer time to do (not useful in acute situations or trauma
It is more expensive and less available
The noise can be disturbing to some patients (children)

how can cerebral vasculature be imaged

MRI and angiography

contrast media (gadolinium compounds)

can enhance MRI and other images in the area of the tumor in which the blood brain barrier has been compromised

what does a functional MRI show

the flow of blood from the paramagnetic effects of deoxygenated hemoglobin

what does a MRI using diffusion tensor imaging show

myelinated axonal pathways in brain and spinal cord

If you were looking for a skull fracture or hemmorahage what type of image would you use?

CT scan

what structure is useful for identifying you are in the posterior 1/3 of the brain

the cerebellum

in a coronal section image of the brain what does the brain stem identify

The brainstem identifies the approximate middle third of the brain

where do the diencephalon, thalamus, and the internal capsule lie

in the center of the brain and is divided by the third ventricle

what can the internal capsule help to identify in the image of the brain

core brain structures. It distinguishes the diencephalon (center, inside) from the lenticular nuclei (lateral, outside) in both coronal and horizontal sections.

where is the caudate nucleus located

also lies inside the internal capsule, on the border of the lateral ventricle.

what are the three main potions of the internal capsule in an axial section

an anterior limb, a genu, and a posterior limb

what does the anterior limb of the internal capsule seperate

the caudate nucleus and the lenticular nuclei

where is the genu

lies at the "notch" in the capsule at the beginning of the thalamus.

what type of imaging uses radiation

CT scan

imaging for a pregnant woman

MRI (because it doesn't use radiation)

gadolinium

contrast used for MRI

type of imaging that shows tumors

MRI

imaging for suspected hemorhage

CT

imaging for suspected skull fracture

CT scan

imaging used for soft tissue

MRI

fast, available, hemorhages, fractures

CT scan

doesn't show infarctions, schemias, edmea and uses ionizing radiation

CT Scan

uses magnets which causes prtotons to spin

MRI

Type of MRI where water is white

T2

Type of MRI where fat is white

T1

type of imaging that is expensive and not good for hemmorrhages and can cause patients to feel closterphobic

MRI

type of imaging that doesn't use radiation, is good for soft tissue

MRI

what compounds does a SPECT test use

I123, techecium-99, xenon-133, thalium-201

compounds used by PET scan

carbon 11, flourine 18, oxygen 15, nitrogen 13

shows functions, shows tumor

PET scan

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