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Flashcards in Imaging the Nervous System Deck (46)
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1

What is the CNS imaging modality of choice in neonates and infants?

Cranial ultrasound

2

Why is cranial ultrasound the imaging modality of choice in neonates and infants?

Due to the ease of scanning via the open anterior fontanelle

3

What are the advantages of cranial ultrasound?

Quick and non-invasive

4

What are the disadvantages of cranial ultrasound?

Highly operator dependant

5

What do repeat cranial ultrasounds over time allow for?

Evolution and progression of lessons to be monitored

6

What is cranial ultrasound particularly used for?

- Intraventricular haemorrhage
- Ischaemic cysts of periventricular leukomalacia (PVL)
- Ventricular dilatation
- Range of cerebral malformations and other lesions, e.g. agenesis of the corpus callosum

7

What is MRI much better at than cranial ultrasound?

- Detecting ischaemic lesions, e.g. hypoxic-ischaemic encephalopathy or PVL
- Detailed anatomy of cerebral malformations

8

What are the advantages of cranial CT?

- Widely available
- Rapid

9

What is cranial CT used for?

- Head trauma
- If clinical condition unstable
- Intracranial calcification
- Haemorrhage

10

How can cranial CT images be enhanced?

With the use of contrast

11

Why has cranial CT been largely replaced by MRI?

- Does not require radiation
- Usually more informative

12

What is MRI imaging the technique of choice?

In most paediatric neurological disorders

13

What is the purpose of different sequences in MRI?

Can be used to interrogate the signal to answer particular clinical questions

14

What are the different sequences in MRI?

- T1
- T2
- FLAIR (fluid attenuated inversion recovery)

15

Describe the appearance of CSF, grey matter, and white matter on T1 MRI sequence?

- CSF appears black
- Grey matter is grey
- White matter is white or paler grey

16

What is T2 sequence used for?

Assessing tissue fluid contents, such as oedema

17

How does CSF appear on T2 MRI sequence?

White

18

What is FLAIR sequence used for?

Lesions close to the ventricles

19

What is the purpose of FLAIR sequence?

Signal from CSF is reduced to allow clearer tissue imaging

20

How does a solid mass appear on;
a. T1
b. T2
c. FLAIR?

a. T1 - dark
b. T2 - bright
c. FLAIR - bright

21

How does a fluid-filled cyst appear on;
a. T1
b. T2
c. FLAIR?

a. T1 - dark
b. T2 - bright
c. FLAIR - dark

22

How does subacute blood appear on;
a. T1
b. T2
c. FLAIR?

a. T1 - bright
b. T2 - bright
c. FLAIR - bright

23

How does a acute and chronic blood appear on;
a. T1
b. T2
c. FLAIR?

a. T1 - grey
b. T2 - dark
c. FLAIR - dark

24

How does fat appear on;
a. T1
b. T2
c. FLAIR?

a. T1 - bright
b. T2 - dark
c. FLAIR - bright

25

What has increased availability of MRI scanning in children allowed for in a wider sense?

Expand knowledge about pathological processes occurring in children with encephalopathy

26

What does functional MRI allow for?

Visualisation of regional oxygen consumption and blood flow

27

What is functional MRI used to examine?

Brain activity

28

What does functional MRI create?

A map showing which parts of the brain are involved in a particular task, such as movement or speech

29

Where is functional MRI being increasingly used?

In pre-surgical assessment of children being considered for epilepsy surgery

30

What does functional MRI allow in the pre-surgical assessment of children being considered for epilepsy surgery?

More accurate prediction of post-op functional outcome