Central nervous system
Guanghui YuRadiology college
Brain
Spinal cord
Central nervous system
Radiographic technique
technique brainSpinal
cord
Image acquisition time
application
Plain film
invisible invisible elimination
CT visible invisible fastEmergency
radiology
MRI visible visible low others
DSA vesselsvascular diseases
Grey and white matter
Neural tissue
Axon (surrounded by myelin)
Cell body (more H2O)
Fatty substance (white in color)
white matter
Grey matter
CT MR T1WI T2WI
white matter hypodense high low
Grey matter hyperdense low high
white matterGrey matter
hyperdense hypodense
T1WI T2WI
hypointensityhyperintensity
(Grey matter)(white matter)
hypointensity
hyperintensity
T1WI FLAIR T2WI
Fluid attenuated inverse recovery
The brain consists of
a 、 the brain stem b 、 the cerebellum c 、 the forebrain
pons
midbrain
medulla oblongata
cerebellum
Spinal cordcerebellar tonil
the forebrain
frontal lobe
parietal lobe
temporal lobe
occipital lobe
insular lobe
Corona radiata
Genu of Corpus callosum
Head of caudate nucleus
Lentiform nucleus
Splenium of Corpus callosum
Thalamus
Internal capsule
External capsule
Basal ganglia
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A midline Post-contrast Sagittal T1 Weighted MRI
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1. Scalp fat2. Bone3. Inferior sagittal sinus4. Corpus callosum5. Internal cerebral vein6. Vein of Galen7. Superior sagittal sinus8. Parietal lobe9. Occipital lobe10. Straight sinus11. Vermis12. IV ventricle13. Cerebellar tonsil14. Cervical cord15. Medulla16. Pons17. Midbrain18. Mass intermedia of thalamus19. Anterior III ventricle 20. Optic chiasm21. Pituitary gland22. Sphenoid sinus23. Nasopharynx24. Frontal lobe
Coronal Section of the Brain at the level of IV VentriclePost Contrast Coronal T1 Weighted MRI
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11. Cerebellar tonsil2. Cerebellar hemisphere3. IV ventricle4. Superior vermis5. Tentorium6. Posterior temporal lobe7. Choroid plexus within lateral ventricle8. Posterior frontal lobe
Meninges
dura mater the outer layer arachnoid mater the middle layer pia mater the inner layer inseparable from the brain
The cranial dura is formly adherent to the periosteum of skull bones
The arachnoid mater is loosely adherent to the dura mater Between the arachnoid and the pia is the subarachnoid space
A double layer of dura projects into the cranial cavity.
These dural folds form:
Falx cerebri
Tentorium cerebelli
Diaphragm of sella turcica
meninges:
arachnoid
pia mater
dura
Falx cerebri
Tentorium cerebelli
Diaphragm of sella turcica
Subarachnoid space
cerebral falx
cerebral falx
Tentorium cerebelli
ventricular system and cerebrospinal fluid
Lateral ventricle
Anterior horn of lateral ventricle
Interventriculer foramenForamen of Monroe
Cerebral aqueduct
Fouth ventricle
third ventricle
posterior horn of lateral ventricleinferior horn of lateral ventricle posterior horn of lateral ventricle
inferior horn of lateral ventricle
pineal body
Cerebrospinal fluid circulation and cistern
Cerebrospinal fluid
Produced by the choroid plexus in all ventricles
the lateral ventricle the third ventricle
Foramen of Monro
the fouth ventricle
cerebral aqueduct
Subarachnoid space
Superior sagittal sinusarachnoid granulation
Median and lateral aperture of fourth ventricle
cistern : At several sites where the surface of the brain is deeply fissured, the subarachnoid space is wider than at other sites.
bilateral : interhemispheric cistern cistern of lateral sulcus cisterna ambiens cistern of pedunculus cerebellaris pontinus
Post Contrast Axial MR Image of the brain
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Post Contrast sagittal T1 Wtd M.R.I.
Section at the level of Pons
Answers
8. Cerebellar Hemisphere
9. Vermis
10. IV Ventricle
11. Pons
12. Basilar Artery
13. Internal Carotid Artery
14. Cavernous Sinus
15. Middle Cerebellar Peduncle
16. Internal Auditory Canal
17. Temporal Lobe
acoustic nerve
facial nerve
unilateral :
dorsal
cisterna venae magnae cerebri
quadrigeminal cistern
ventral
cistern of chiasma
interpeduncular cistern
suprasellar cistern
consecutive
suprasellar cistern
hexagon
chiasma
Cerebral peduncle
interpeduncular cistern
suprasellar cistern
Vertebralartery
basilar artery
basilar artery posterior cerebral artery
middle cerebral artery
anterior cerebral artery
posterior communicating artery
internal carotid artery
cranial sinuses
Pituitary gland
anterior pituitary adenohypophysis
posterior pituitary neurohypophysis
Pituitary gland
• MR thin slice scan Coronal and sagittal scan
• Height:<7millimeter
• superior margin: flat or depressed
• Pituitary stalk:<4millimeter
Coronal Section of the Brain at the level of Pituitary glandPost Contrast Coronal T1 Weighted MRI
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1. Frontal lobe2. Corpus callosum3. Frontal horn4. Caudate nucleus5. III ventricle6. Optic nerve7. Pituitary stalk8. Pituitary gland9. Internal carotid artery10. Cavernous sinus11. Sphenoid sinus12. Nasopharynx
Normal calcification : pineal body 、 cerebral falx 、 choroid plexus 、globus pallidus
Contrast enhancement : pituitary gland 、 pineal body 、 dura 、 choroid plexus
Fig. 1.7 Post Contrast Axial MR Image of the brain
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Post Contrast sagittal T1 Wtd M.R.I.
Section at the level of Corpus Callosum
Answers39. Splenium of corpus callosum
40. Choroid plexus within the
body of lateral ventricle
41. Genu of corpus callosum
Fig. 1.11. Coronal Section of the Brain at the level of IV VentriclePost Contrast Coronal T1 Weighted MRI
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11. Cerebellar tonsil2. Cerebellar hemisphere3. IV ventricle4. Superior vermis5. Tentorium6. Posterior temporal lobe7. Choroid plexus within lateral ventricle8. Posterior frontal lobe
Abnormal changes of CT scan
a 、 hyperdense : calcification 、 hemorrhage 、tumor
b 、 hypodense : edema 、 tumor 、 cystis 、liquefactive necrosis 、 lipoma 、 fluid
c 、 isodense : chronic hamorrhage 、 tumor
d 、 heterogeneous density :
calcification
value >100Huexceed
Abnormal change of MRIA 、 T1WI : a. hyperintensity : fat or lipoid 、 melanin 、 constrast
medium
b. hypointensity : edema 、 fluid 、 tumor 、 fibrosis and calcification
B 、 T2WI : a. hyperintensity : edema 、 fluid 、 tumor 、 b. hypointensity : fibrosis and calcification 、
melanin
C 、 mass effect
mass
mass
evolution of hematoma and intensity of MRI
T1WI T2WIferrohemoglobin iso- iso-ferrohemoglobin iso- hypo-methemoglobin akaryocyte hyper- hypo- membranolysis hyper- hyper-hemosiderin hypo- hypo-
A week laterAcute
methemoglobin
hemosiderin
Hydrocephalus (increased volume of cerebrospinal fluid)
1 、 obstructive hydrocephalus
2 、 communicating hydrocephalus
3 、 exterior hydrocephalus
communicating hydrocephalus
Cerebral aqueduct
obstructive hydrocephalus
exterior hydrocephalus
exterior hydrocephalus
edema
type location cause water
vasogenic edema
white matter Tumor
inflammation
trauma
hydrated water
cytotoxic edema
white matter and grey matter
acute infarction
few
vasogenic edema
cytotoxic edema
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