Morning CME 2 - Radiology

Summary:

3 axes

• Axial - transverse ,i.e from up to down slices
• Sagittal - Right to left(lateral)
• Coronal - anterior to posterior
• In CT - morphological characteristic seen
• In MRI - anatomy seen properly

CT

• Grey matter seen light coloured
• White matter more grey
• Hyperdense ( solid ) matter appears white like blood, bone ,calcification
• Hypodense appears dark or black like CSF,fluid, abscess,air,fat.
• Fractures seen more clearly in CT
• Also if paralysis or weakness within 15 mins do CT first – helps in diagnosis

Hypertensive bleed -arterial mainly centrally (thalamus)

Venous bleed - peripheral

1. Epidural bleed – between bone n dura
   • Not free flowing
   • Shape concavoconvex ( like lemon)
   • Cause is fracture
   • Mostly arterial
2. Subdural -between dura n arachnoid- banana shaped seen
   • In old age, h/0 fall
3. Subarachnoid – inside brain
4. Interventricular bleed

Normal pressure hydrocephalus

• Seen in old age
• Less atrophy with more ventricular dilatation
• Triad of ataxia,cognitive impairmentn urinary incontinence

Epilepsy

• Temporal region mainly -hippocampus(medial most part)
• Seen in coronal image
• Hippocampus seen lateral to choriod sulcus n below temporal horn

MDD

• Functional MRI, PET more helpful
• MRI- in old age-white dots seen in brain
• In young- subcortical white matter – white dots seen
• Hippocampus atrophy seen

Alzeihmers

• Amyloid in small vessels (surpenginous white dots)
• Atrophy seen
• Slyvian fissure dilated
• Hippocampus atrophy
• Temporal horn dilated

Schizophrenia

• Thinned cortex
• Enlarged 3rd ,lat ventricle
• Reduced hippocampus

Alcohol abuse

• Inappropriate brain atrophy
• more of middle side of thalamus
• 40 years vale ka brain 60 vale jaisa
• widening of cerebellar fossa
• dilatation of sulci

OCD

• Atrophy of caudate nucleus seen