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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.

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


CHIARI III


• AGENEZIA

CORPULUI

CALOS


• LIPOM


• MALFORMAȚIE DANDY

WALKER


• HOLOPROSECEFAL


• MICROCEFAL


• 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

• 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


• ABCES CEREBRAL


• 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

Anatomy

Plain X-Ray

A-P view Lateral view Oblique view

MYELOGRAPHY

Degenerative Spondylolisthesis

MRI

T1 WI T2 WI


• CIFOZĂ

T1w T2wir

Sagittal View

MRI

ANOMALII DE DEZVOLTARE • HEMIVERTEBA


• VERTEBRĂ

ÎN

FLUTURE

ANOMALII DE DEZVOLTARE • BLOC

VERTEBRAL

• LIPOM

INTRADURAL


• SIRINGOMIELIA


• 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

neuroradiology - usmf...•chist hidatic cerebral angiography •catheter angiography:...

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