CT SCAN - MRI

CT SCAN
Computed tomography scaning
uses X-rays and a computer to create
detailed images of the inside of the
body.
used to diagnose and monitor a different
health conditions, including brain tumours,
certain bone conditions, and injuries to
internal organs such as the kidneys, liver
or spleen. They're also now being used to
look at the heart.

CT Scan Diagnosis
Blood Can Be Very Bad
Blood :
Acute : hyperdense (bright white)
Sub acute (4 days 2 weeks :
isodense, begin at periphery & move
centrally
>2-3 weeks : darker than brain

Epidural Hematoma (EDH)

A lens shape (biconvex)
85% from artery laceration due to direct trauma
(acute state)

Sub Dural Hematoma (SDH)

A sickle / crescent shape
Can be Acute / chronic

Intraparenchymal/
Intracerebral
Hemorrhage (IPH / ICH)

Intraventricular
hemorrhage (IVH)

Sub arachnoidea Hemorrhage (SAH)

Hemorhage into CSF space
CT sensitivity decreased
with time

C : Cisterne
CSF collection surrounding the brain

Circummesenchepalic : ring around midbrain

Suprasellar : star-shaped
Quadrigeminal : W-shaped at top midbrain
Sylvian : between temporal frontal lobes

Check for blood, asymetry

B : Brain
Check : simetry, grey-white differentiation,
shift
Tumour / Abses

Ischemic infarcation

V : Ventricle
Compression/Shift

hydrocephalus

B : Bone
Skull fracture : note of soft tissue sweling,
intracranial air

Clinical reasoning
Abnormality found in Head / brain CT scan
CNS disorder UMN dysfunction :
hemiplegia, aphasia, amnesia, etc
UMN dysfunction depend on severity &
location of abnormality prognosis

CT Scan : Spinal Collumn

Check for alignment, disc density,
diameter of foramina
Without contrast
With contrast (CT Myelography)

cervical

thoracal

lumbal

 B : vertebral body; P : pedicle;

T : transverse process; L ; laminae;
SC : spinal canal ; SP : spinous process

B : vertebral body;
L ; laminae;
SC : spinal canal ;
SP : spinous process
NR : nerve root
Ps : psoas muscle
Pa : paraspinal muscle

D : disc
SC : spinal canal ;
SP : spinous process
NR : nerve root
Ps : psoas muscle
Pa : paraspinal muscle
S : superior art. process
I : inferior art. process
F : facet joint

3 D CT SCAN

3 D CT SCAN

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI)

Cell contains protons within a magnetic field,
the protons in his/her cells align like small
magnets protons becoming excited and
moving out of their original position. return to
their baseline state (relax) energy
transduced translated into images.

T1 & T2

Advantages of MRI
Harmless to the patient - no radiation is involved
(unlike computed tomography (CT) scanning
and conventional radiology).
Excellent detail makes it similar, and even
superior to, CT scanning in some situations.
MRI contrast agent used is normally gadolinium
which is less allergenic than iodine-based
contrast agents used in CT scanning.

Disadvantages of MRI
Extreme precautions must be taken to keep metallic
objects out of the room where the machine is operating
People with pacemakers can't safely be scanned
Some people suffer from claustrophobia, and find the
confinement discomforting
The machine makes a very loud continuous hammering
noise when operating
Some people are too big to fit inside the magnet
MRI scans require patients to hold very still for long
periods of time ... up to 90 minutes or more
MRI systems are expensive to buy and run so are
currently beyond most DGHs

Magnetic Resonance Imaging

(MRI)
T1 vs T2

T1 WI
Characteristics
Fat is Bright
Fluid is dark
Muscle is
indeterminate
Bad things are
usually darkish
Good detailshort
time sequence

T2 WI
Fluid Sensitive
Sequence

Fluid is bright
Fat is
indeterminate
Bad things are
usually bright
Longer time

Hasil MRI pasien wanita, 50 tahun

dengan keluhan LBP tanpa
gangguan neurologis