Imaging Anatomy of the CNS

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Imaging Anatomy of the CNS

• Jobi Whiting, M.D.
• Department of Neurological Surgery
• University of Florida

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Basic Imaging Types

• X-ray
• CT (Computed Tomography)
• MRI (Magnetic Resonance Imaging)
• Angiography

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X-ray

• Limited Use
• Evaluation of
• Bones, fractures
• Calcification
• Hardware

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X-ray
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Computed Tomography
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What is CT?

• X- ray study, therefore has risks.
• Beams of X-ray are shot through object, and
  received on the other side.
• This is done in a 360o manner.
• Computer reconstructions of each 360o turn gives
  us each image slice.
• Based on tissue density.
• Sections only in axial plane.

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Magnetic Resonance Imaging
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What is MR?

• Not an X-ray, electromagnetic (similar to
  microwave)
• Electromagnetic field aligns all the protons in
  the brain.
• Radiofrequency pulses cause the protons to spin.
• Amount of energy emitted from the spin is
  proportional to number of protons in the tissue.
• No ferromagnetic objects.

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Angiography
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Angiography

• Real time X-ray study
• Catheter placed through femoral artery is
  directed up aorta into the cerebral vessels.
• Radio-opaque dye is injected and vessels are
  visualized
• Gold standard for studying cerebral vessels.

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Angiography
AP Right ICA
Lateral Right ICA
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Angiography
AP Right Vertebral
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Planes of Section

• Axial (transverse)
• Sagittal
• Coronal (frontal)
• Oblique

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What is an AXIAL section?
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MRI Weighting
T1 Weighted MRI
T2 Weighted MRI
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Normal Brain Anatomy

• Consider
• What is the structure?
• What are its surfaces?
• What are the adjacent spaces and structures?
• What are adjacent vessels?

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Sagittal Localizer
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Section 1Cervicomedullary Junction
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Cervico-medullary Junction
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Section 2Lower Medulla
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Lower Medulla
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Section 3 Upper Medulla Caudal 4th Ventricle
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Upper Medulla Caudal 4th ventricle
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Section 4Pons 4th Ventricle
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Pons 4th Ventricle
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Pons 4th Ventricle
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Section 5Midbrain Sylvian Aqueduct
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Midbrain Sylvian Aqueduct (T1)
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Midbrain Sylvian Aqueduct (T2)