Podcast
Questions and Answers
Based on the information provided, what did the interpreting radiologist conclude about the initial non-contrast CT head?
Based on the information provided, what did the interpreting radiologist conclude about the initial non-contrast CT head?
- There is evidence of a right sided infarct.
- There is a suspicious CT abnormality to correlate with the patient's symptoms. (correct)
- There is no acute infarct. Consider EEG.
- There is no evidence of acute infarct. Send the patient home.
Which imaging modality is the most sensitive for evaluating an acute brain infarct?
Which imaging modality is the most sensitive for evaluating an acute brain infarct?
- CTA head with contrast
- MRA brain without contrast and MRA neck with contrast
- CT head with contrast
- MRI brain without contrast (correct)
According to the information provided, which of the following is a characteristic CT finding of an acute cerebral infarct?
According to the information provided, which of the following is a characteristic CT finding of an acute cerebral infarct?
- Hyperintense on T1 and hypointense on T2/FLAIR
- Hyperdense (bright) vessel sign (correct)
- Sulcal effacement or asymmetrically larger sulci
- Hypointense on DWI
Which of the following is a characteristic MRI finding of an acute cerebral infarct?
Which of the following is a characteristic MRI finding of an acute cerebral infarct?
What is the appropriate next step in imaging for this patient, based on the information provided?
What is the appropriate next step in imaging for this patient, based on the information provided?
Which of the following is a common limitation of non-contrast CT in the evaluation of acute cerebral infarction?
Which of the following is a common limitation of non-contrast CT in the evaluation of acute cerebral infarction?
Which of the following statements accurately compares CT and MRI?
Which of the following statements accurately compares CT and MRI?
Which of the following organizations publishes appropriateness criteria for clinical imaging exams?
Which of the following organizations publishes appropriateness criteria for clinical imaging exams?
Which of the following factors should be considered when selecting between CT and MRI for imaging?
Which of the following factors should be considered when selecting between CT and MRI for imaging?
Which imaging modality is generally preferred for patients with pacemakers or aneurysm clips?
Which imaging modality is generally preferred for patients with pacemakers or aneurysm clips?
What is a key advantage of MRI over CT in terms of patient safety?
What is a key advantage of MRI over CT in terms of patient safety?
Which type of Le Fort fracture is characterized by involvement of the zygomatic arch?
Which type of Le Fort fracture is characterized by involvement of the zygomatic arch?
Which of the following is NOT a typical indication for using IV gadolinium contrast in MRI neuroimaging?
Which of the following is NOT a typical indication for using IV gadolinium contrast in MRI neuroimaging?
Which neuroimaging modality is typically performed without contrast for evaluating the head and neck vasculature?
Which neuroimaging modality is typically performed without contrast for evaluating the head and neck vasculature?
When would a CT of the head and neck soft tissues typically be performed with contrast?
When would a CT of the head and neck soft tissues typically be performed with contrast?
Study Notes
Acute Cerebral Infarct
- 61-year-old female presents with acute onset right-sided weakness and aphasia, history of atrial fibrillation, hypertension, COPD, and discontinued anticoagulation due to frequent falls
- Interpreting radiologist concludes that there is evidence of a right-sided infarct
Imaging Modalities for Acute Brain Infarct
- Most sensitive imaging modality: MRI brain without contrast (hyperintense on DWI)
- CT head: may not show acute infarct, especially in the first few hours; signs include hypodense areas, loss of gray/white differentiation, and swelling/edema
- MRI: hyperintense on DWI, hypointense on T1, and hyperintense on T2/FLAIR; signs include loss of gray/white differentiation and sulcal effacement
CT vs MRI
- CT: cheaper, faster, uses ionizing radiation, and has lower patient cooperation requirements
- MRI: more expensive, takes longer, does not use ionizing radiation, and requires higher patient cooperation
ACR Appropriateness Criteria
- Published by the American College of Radiology (ACR)
- Extremely helpful for determining appropriateness of clinical imaging exams
Neuroimaging Exams
- CT Neuroimaging exams: usually performed without contrast, except for CTs of head and neck soft tissues, CT angiograms, and CT venograms
- MR Neuroimaging exams: IV gadolinium contrast indicated for infection, primary tumors or metastatic disease, demyelinating disease, and a few others; not usually necessary for stroke, trauma, or degenerative spine disease
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Description
Learn about the differences between CT and MRI scans, including cost, safety, acquisition time, patient cooperation, and use of contrast material. Understand the appropriateness criteria for choosing between CT and MRI in medical imaging.
