????????? Neuroradiology

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?????????Neuroradiology
??

• ??? M. D.
• ?????????
• 2004.6.21

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?????

• ??????????
• ?CNS????????????,???????????
• ????????????????????????

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????

• ??????????????????
• ????????????????????

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Part I imaging technique and prospects ?????????
?????

• ????
• ?????
• ?CT
• ????
• SPECT/PET
• ??TCD

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? ? ? ?(plain radiography of skull)
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????(????)
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??(X?)

• X??????? ???????????????
• X??????,???????????,???X???

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??????????

• ?????????
• ?????????????????
• ??????,????????CT
• ?????????,????????????
• ??????????,?????????,???????????

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?????(cerebral angiography)
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?????
??DSA??,?????????
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DSA(digital substraction angiography)??

• ????? ??DSA(intraarterial DSA)
• ???????????(temporal subtraction method)
• ??????????????,????????????????????????10?(1?/?)
• ?1????????????????????????(??),????????????
• ?????????
• ????Digital?
• ????????????
• ??????????????,?????????

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????????

• ??????????????????
• ??????????
• ????????!----??????
• ??
• Coil(??)???????????
• ??????????????
• ??

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CT(Computed Tomography, ???????)
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?CT
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CT???????

• ??X???
• ??????????????
• ??????????????X?????
• ?????????,?????????
• CT??????????

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????CT vs ????CT
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?????16???CT

• Sensation 16( Siemens)
• ???
• ??????
• ??????
• ??????????

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Lets have a look!
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Neuro CT---- CT?CNS???

• ????????????,?????CT??????
• ??????????
• ?????????????
• CT??
• ??,??
• ???????????????
• ?CT??????,???????
• CT????(CT angiography, CTA)
• CT ?????(CT perfusion)

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CTA(CT????)

• ????CT???
• ??????????CT ??
• ???????3D???
• ??CTA??
• ??(?DSA??)
• ??,??,???
• ?????????
• ????

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Perfusion CT(CT???)
MIP-flow-volume-time to peak
???????,???????????,???????????,????-????,????????
?? ??????????????????? ????????
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? ? ?(Magnetic Resonance Imaging, MRI)
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???--???????????!
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MRI Nobel Prize

• 2003?????????????????????????????????????,??????
  ???????????????(for their discoveries concerning
  "magnetic resonance imaging)?
• ???????????????????????

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MRI Nobel Prize
???? (Paul Lauterbur,1929?????)
?????1973???,?????????????,????????????,??????????
????????????????????
????? (Peter Mansfield,1933?????)
????????????????????,???????????????????,?????????
????????????????????????????????????????
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MRI( Magnetic Resonance Imaging)

• ????????( Nuclear MRI)
• ???????,??????
• ????????????,?????(MRI)
• ?????
• ???????
• ?????????????
• ???????
• ??????????
• ????MR?????

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MRI???????
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MRI tips

• MRI??????????
• ???????????????????????
• ????3?????????
• ????(proton density)
• ????????(T1 relaxation time)
• ????????(T2 relaxation time)
• ???????????????????,??????????????MR??,????????(PD
  WI)?T1???(T1WI) ?T2???(T2WI)
• ?????????????????????
• ??????????????????,?????MR???????
• ??????????? ,????????????

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MRI?????

• MRI ??---?????????
• MR????MR Angiography,MRA
• ---????????????
• MR????Perfusion MRI
• MR????Diffusion MRI
• MR??????Diffusion Tensor Imaging, DTI
• MR??MR spectroscopy, MRS
• ???????functional MRI, fMRI
• ??MR???????,et al.

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MRA

• MR????,?????

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Diffusion Perfusion MRI
T2WI
DWI
rCBV

• DWI??????????(??)

Perfusion MR ?Perfusion CT??
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??????(DTI)

• ???????????????????????????
• ??????????????????????(Fractional Anisotropy,
  FA?)
• ????
• ????
• ??????
• ????
• ?????
• ?????
• ??
• et al.

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MR ??(MRS)

• ??MR??????????
• ??????????????
• ?????1H??

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Functional MRI

• BOLD(blood oxygen level dependent)??
• ???????????,??????????????????,???????????????????
  ???????????????????????????????????,???T2?????????

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SPECT/ PETSingle Photon/ Positive Electron
Emission Tomography(???/?????????)
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SPECT/ PET

• ???????????????????, ??????/?????????(??CT????X?)?
  
• ?????????????????
• ?????????????????????????????????
• ?????????

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????!
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Part II imaging features????????????????
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?????????????
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CT ??

• CT?--???X??????--??
• ?????,??CT???,??????
• ???CT???0,?????1000,????-1000??????

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MRI??

• T1???
• --?????---
• ?????????
• ??????(????)

T2??? --?????--- ????????? ??????
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Cases for Demo
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???
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???MR????

• ????(lt24??)-------??????????--?T1??T2
• ???(1-3?)------------??????????--??T1??T2
• ??????(3-7?)---??????????--?T1??T2
• ??????(7-14?)--??????????--?T1??T2
• ???(gt14?)------------?????????
• 
  - -???T1??T2, ????T1??T2

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???
???(1-3?)
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???
?????(3-7?)
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???

• F45,?????????????2hrs.

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????????????????
?????
?????
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??????????

• ?????MCA M1?

????MCA??
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?????????????!

??
??
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?????--AVM
M34, ????,?????-?????
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?????
M73, ???, ?????1?,???????? ???II???????????
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?????II?
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???--??????
M62, ?????????????????? ????,????????
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Neoplastic lesion--?????
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(No Transcript)
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??????
7????,??????
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Anoxic brain injury

• Different tissue sensitivity to adult
• Global injury
• MRI useful for prognosis
• MRS helpful in equivocal cases

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??????-?????

• M30, ??????(13yrs),???????????(24yrs)

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Thank you!
Email jjlupumc_at_public.bta.net.cn (o) 65295480