Scribd
Upload
60 views

Imaging of Traumatic Brain Injury

1) Traumatic brain injury affects over 1.7 million Americans per year, causing 275,000 hospitalizations and 52,000 deaths, with an annual economic cost of $76.3 billion. 2) Neuroimaging plays an important role in both the acute and chronic stages of traumatic brain injury by determining the presence and extent of injury to guide surgical planning or rehabilitation. 3) Computed tomography (CT) is fast, readily available, and excellent for detecting hemorrhage and fractures, while magnetic resonance imaging (MRI) provides better soft tissue resolution without radiation but has longer scan times.

Uploaded by

Charithe Lakshithe Chandanayake
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
60 views

Imaging of Traumatic Brain Injury

1) Traumatic brain injury affects over 1.7 million Americans per year, causing 275,000 hospitalizations and 52,000 deaths, with an annual economic cost of $76.3 billion. 2) Neuroimaging plays an important role in both the acute and chronic stages of traumatic brain injury by determining the presence and extent of injury to guide surgical planning or rehabilitation. 3) Computed tomography (CT) is fast, readily available, and excellent for detecting hemorrhage and fractures, while magnetic resonance imaging (MRI) provides better soft tissue resolution without radiation but has longer scan times.

Uploaded by

Charithe Lakshithe Chandanayake
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 31

Imaging of Traumatic Brain Injury

GAURAV JINDAL MD
Assistant Professor in Radiology
Brown University
Rhode Island Medical Imaging
DISCLOSURES
• None
• Traumatic brain injury affects approximately 1.7 million Americans per
year, 275,000 hospitalizations and 52,000 deaths each year.
• TBI contributes to one-third of all injury-related deaths in the United
States.
• Annual economic cost of TBI estimated at $76.3 billion
• Neuroimaging plays an important role in both acute and chronic stages
of TBI
• In Acute TBI: Imaging studies determine the presence and extent of
injury and guide surgical planning
• In Chronic TBI: Sequelae of prior injury, determining prognosis and
guiding rehabilitation
OBJECTIVES
1. Discuss the basic principles of Neuroimaging (CT and MRI)
2. Overview of normal brain anatomy
3. Imaging findings and prognostic implications in TBI
BASICS OF CT IMAGING
How far have we come?
• In the 1970-80s, it took 120 minutes to perform a CT head
• 1990s, it took about 15-20 minutes
• Today: ?
How far have we come?
• In the 1970-80s, it took 120 minutes to perform a CT head
• 1990s, it took about 15-20 minutes
• Today: 5 seconds
How is the CT image generated?
• An X-Ray beam passes through the patient
• Based on the densities of different tissues, the X-rays get differentially
absorbed.
• Complex mathematical algorithms finally generate the CT image
based on the absorption spectrum of the detectors.
• CT MEASURES DENSITY
BASICS of MRI
• The MR machine houses a powerful magnet (x1000s compared to
Earth’s magnetic field)
• Complex interplay of exciting hydrogen atoms in the body tissues via
radiofrequency pulses and analysing signals based on repeated
excitation and deexcitation of protons
• MRI does not involve use of radiation
What test to order?
• CT or MRI
• CT without contrast
• CT without and with
contrast
• MRI without/MRI with
• CTA
• MRA
Some general rules:
• For any ACUTE neurological condition: Head CT
• For SUBACUTE/CHRONIC cases: Brain MRI
• CT Brain is almost always performed without IV contrast
• Plain radiographs of the skull: OBSOLETE
CT MR

• Exquisite anatomical detail


• Fast • No radiation
• Readily available • Longer scan time
• No screening • Screening( Pacemaker, metallic
• Excellent for detecting implant, orbital foreign body….)
hemorrhage and fractures • Claustrophobia
• Poor soft tissue resolution • Challenging with unstable
• Ionizing radiation patients
BASIC ANATOMY
• 3 main imaging planes:
i. Axial
ii. Coronal
iii. Sagittal
• CT images are acquired in the axial (transverse) plane
• MRI images can be acquired in any plane
AXIAL ‘SLICE’

R L
CORONAL
SAGITTAL
Brain Anatomy
• Cerebral hemispheres:
 Frontal
 Parietal
 Temporal
 Occipital

• Cerebellum
• Brainstem
• Ventricles
• CSF spaces
• Calvarium
CT Windows

BRAIN WINDOW BONE WINDOW


MRI WINDOWS/SEQUENCES

AXIAL T1 AXIAL T2 AXIAL DIFFUSION


Important principles:

• SYMMETRY is key
• Midline structures should always be in midline
• CSF spaces should be preserved
• Ventricle size

You might also like