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NEURORADIOLOGY
Imaging Modalities
• Conventional Radiography • Computed Tomography • Magnetic Resonance Imaging • Ultrasonography • Angiography • Scintigraphy, Positron Emission
Tomography, PET/CT
Posteroanterior Skull Projection Is used for documentation of skull and facial skeletal asymmetries.
Lateral Skull Projection Is used for documentation of skull and facial skeletal asymmetries.
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.
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.
Computed Tomography
• Spiral CT – X-ray tube rotates continuously around the
patient.
Computed Tomography
MAGNETIC RESONANCE IMAGING
(MRI)
MRI
Uses magnetic fields and radio waves
to produce images of thin slices of
tissues (tomographic images).
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.
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.
MRI
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)
Normal MR Brain
T1 Weighted Image T2 Weighted Image
Sagittal MR Brain
T1 WI
• ANOMALII DE DEZVOLTARE
• TRAUMATISMUL CRANIOCEREBRAL
• ACCIDENTUL VASCULAR CEREBRAL
• PROCESE TUMORALE
• PROCESE INFECȚIOASE
ANOMALII DE DEZVOLTARE
CHIARI I
ANOMALII DE DEZVOLTARE
CHIARI III
ANOMALII DE DEZVOLTARE
• AGENEZIA
CORPULUI
CALOS
ANOMALII DE DEZVOLTARE
• LIPOM
ANOMALII DE DEZVOLTARE
• MALFORMAȚIE DANDY
WALKER
ANOMALII DE DEZVOLTARE
• HOLOPROSECEFAL
ANOMALII DE DEZVOLTARE
• MICROCEFAL
ANOMALII DE DEZVOLTARE
• HETEROTOPIA SUBSTANȚEI
CENUȘII
TRAUMA
Plain X-Ray
SKULL FRACTURE
Fracture
Line
Extradural Hematoma
TRAUMATISMUL
CRANIOCEREBRAL
• HEMATOM
EPIDURAL
Subdural Hematoma
TRAUMATISMUL
CRANIOCEREBRAL
• HEMATOM
SUBDURAL
Subarachnoid Hemorrhage
TRAUMATISMUL
CRANIOCEREBRAL
• HEMORAGIE
SUBARAHNOIDIA
NĂ
TRAUMATISMUL
CRANIOCEREBRAL • CONTUZIE CEREBRALĂ
Digital Image Soft Tissue Window Bone Window
Brain Contusions
Hemorrhagic Contusions
Brain Lacerations
Gunshot Injury
R
AVC
• HEMORAGIE INTRACEREBRALĂ
AVC
• HEMORAGIE
INTRACEREBELOASĂ
Acute Middle Cerebral Infarct
AVC
• AVC ISCHEMIC ÎN FAZA ACUTĂ
AVC
• AVC ISCHEMIC CEREBELOS ÎN FAZA
ACUTĂ
AVC • AVC ISCHEMIC ÎN FAZA
CRONICĂ
PROCESE TUMORALE
• Astrocitom
PROCESE TUMORALE
• Astrocitom fibrilar
• Glioblastom
Glioma
T1 WI T2 WI T1 WI Post-Contrast
PROCESE TUMORALE • Oligodentrogliom
Brain stem Glioma
PROCESE TUMORALE
• Meningiom
PROCESE TUMORALE
• Meningiom
PROCESE TUMORALE
• Meningiom
• Meningiom
PROCESE TUMORALE
• Meningosarcom
Pituitary Adenoma
Acoustic Neurinoma
T1 WI T1 WI Post Contrast
MRI
LEZIUNI NON-TUMORALE
PROCESE INFECȚIOASE
• ENCEFALITĂ
HERPETICĂ
Pyogenic Brain Abscess
PROCESE INFECȚIOASE
• ABCES CEREBRAL
PROCESE INFECȚIOASE
PROCESE INFECȚIOASE
• MENINGITĂ TB
(postcontrast)
• TB
CEREBRALĂ
PROCESE PARAZITARE
• NEUROCISTICERCOZĂ
PROCESE PARAZITARE
• CHIST HIDATIC
Cerebral Angiography
• Catheter Angiography: – Conventional
– Digital Subtraction
• Magnetic Resonance Angiography (MRA)
• Computed Tomography Angiography (CTA)
Before After
Embolization of AVM
MR Angiography
Anterior Communicating Artery
Aneurysm
Middle Cerebral Artery Aneurysm
CT Angiography
SPINE
Anatomy
Plain X-Ray
A-P view Lateral view Oblique view
MYELOGRAPHY
CT
Degenerative Spondylolisthesis
MRI
T1 WI T2 WI
ANOMALII DE DEZVOLTARE
• CIFOZĂ
T1w T2wir
Sagittal View
MRI
ANOMALII DE DEZVOLTARE • HEMIVERTEBA
ANOMALII DE DEZVOLTARE
• VERTEBRĂ
ÎN
FLUTURE
ANOMALII DE DEZVOLTARE • BLOC
VERTEBRAL
• LIPOM
INTRADURAL
ANOMALII DE DEZVOLTARE
• SIRINGOMIELIA
ANOMALII DE DEZVOLTARE
• SCOLIOZĂ
Traumatic Cord Contusion
T2 WI
T1 WI T2 WI
Disc Herniation MRI
Infective Spondylitis
T1WI T1WI Post Contrast
PROCESE TUMORALE
Glioma
T1 WI POST CONTRAST
Meningioma
T1 WI POST CONTRAST
Neurinoma
MRI CT
Soft tissue Window
Bone Window
Metastases