Neuroradiologie

#Neurologie #Radiologie

CT

Kenmerken Indicatie
CT zonder contrast Oedeem hypodens
Bloed
hyperdens
Oedeem met blurring gray-white matter area (ischemic infarction)
CT met contrast Small contrast enhacing nodular lesions due to deficient BBB Kleine metastasen
CT angiografie / venografie Direct visualizations of cerebral arteries or veins Infarct, occlusie
Veneuze thrombose (no contrast in sinuses)
CT perfusie Differentiatie tussen penumbra en core Bij ischemic stroke
Important

CT superieur voor: - acute pathologie- bony pathologie

MRI

Basic tools

Kenmerken Indicatie
T1-weighted image Water zwart
Grijze stof grijs
Witte stof wit
Most pathology is dark
Hyperintensity voor
bloed, mineralen, vet & proteins
T2-weighted image Water wit
Grijze stof wit
Witte stof grijs
Pathology sequence
FLAIR T2-sequence in which water is black Pathology sequence
Vaak duidelijker dan T2
DWI Diffusion restriction → white
Infarcted brain tissue shows increased diffusion restriction
Main indication is acute ischemic infarction
ADC Black on ADC map confirms true diffusion restriction (and not T2-shine trough)
T2*-images Magnetic susceptibility artefacts are also made visible (Micro-) hemorrhages
SWI Like T2* but more sensitive (Micro-) hemorrhages

Specific tools

Kenmerken Indicatie
T1 + Gadolinium Gadolinium shortens T1-relaxation time Pathology associated with deficient BBB
3D-TOF-angiografie Signal of stationary tissue is repressed = MR angiografie
3D-MPRAGE Thin-sliced T1-weighted sequence
CISS, 3D-FIESTA Thin-sliced T2-weighted sequence Visualization of small cranial nerves

Advanced tools

Kenmerken
MRI perfusion Visualize changes in brain perfusion
MR spectroscopie Visualize biochemical or molecular composition
Functional MRI Visualize small changes in blood flow associated with specific brain activity
DTI Visualize white matter tracts
Important

MRI voorkeur voor meeste neurologische indicaties en heeft superieur soft-tissue contrast ivm CT