Ebook FRCR 2B Viva-A case-based approach: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook FRCR 2B Viva-A case-based approach: Part 2
Ebook FRCR 2B Viva-A case-based approach: Part 2
4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2adiology as part of their viva, with MR1 playing a larger role here than in other organ systems.Basic approach to brain MR1:o Briefly look al all of the films to see what sequences were performed, in which plane, and whether there are any postcontrast images, as this may provide a clue to rhe pathol Ebook FRCR 2B Viva-A case-based approach: Part 2ogy.Ồ Remember that although the axial plane is the primary plane for neuroimaging, orientation may often he a clue to rhe underlying pathology: for eEbook FRCR 2B Viva-A case-based approach: Part 2
xample, coronal views are always performed when evaluating rhe sella as well as temporal lobe anatomy for refractory seizures. Sagittal views are usef4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2ges, fat appears bright, and therefore rhe myelin sheaths of white matter appear blighter than grey mailer. Tl-weighled images are most useful for anatomical derail, and usually contrast-enhanced sequences rend to be Ì1-weighted. Do not assume that hyperinlensily on a posreonrrasr sequence is enhanc Ebook FRCR 2B Viva-A case-based approach: Part 2ement: always check with the noncontrast images to confirm.©The signal intensity on T2-weighred imaging depends on water content and, as fat is darkerEbook FRCR 2B Viva-A case-based approach: Part 2
than on T1-weighted imaging: white matter appears darker than grey matter on this sequence. T2-weighted images arc most sensitive for detecting patho4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2eighted with the cerebrospinal fluid (CSF) signal suppressed and are particularly helpful in the assessment of periventricular lesions.0 Contrast does nor enhance rapidly flowing blood, so different techniques such as gradient-echo and magnetic resonance angiography are used for the evaluation of va Ebook FRCR 2B Viva-A case-based approach: Part 2scular structures. Due to the magnetic susceptibility of blood, gradient-echo imaging has been shown to be a sensitive method of detection of chronicEbook FRCR 2B Viva-A case-based approach: Part 2
haemorrhage.0 Table 4.1 illustrates the signal characteristics of the evolution of haemorrhage with time.In general, there are three types of cases th4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2ely obvious and a systematic review is required©Cases where the abnormality is obvious and hence would merit a detailed discussion.The “Aunt Minnies”o It is important to prepare for these cases as a candidate may potentially achieve a high score: this is especially true in cases with a classic const Ebook FRCR 2B Viva-A case-based approach: Part 2ellation of findings. Neurocutancous syndromes and congenital malformations are conmion examples.© If you are able to recognise rhe constellation of fEbook FRCR 2B Viva-A case-based approach: Part 2
indings but unable to collate them into an unifying diagnosis, roll rhe examiner that you will arrive ar a conclusion after seeking more information f4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2mal grey-white matter differentiation, and any evidence of haemorrhage.•However, pathology can bo symmetrical, for example, bilateral thalamic infarcts are often missed on CT.©Ventricles and subarachnoid spaces:•Look for symmetry and the presence of haemorrhage (commonly missed in rhe inrer-penduncu Ebook FRCR 2B Viva-A case-based approach: Part 2lar cistern, posterior Sylvian fissures, and dependent occipital horns).•Ensure the basal cisterns are not effaced.© Dura and subdural spaces:•The falEbook FRCR 2B Viva-A case-based approach: Part 2
x is normally denser than the brain parenchyma, but again asymmetry may give a clue to subdural haemorrhage adjacent to the falx (commonly missed in t4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2uid level, within the paranasal sinuses, middle ear cavity, or mastoid air cells should raise the possibility of fractures within the adjacent bone.•Sometimes looking at the scout view can demonstrate an obvious fracture.©Always mention that you would review on the appropriate window settings for ea Ebook FRCR 2B Viva-A case-based approach: Part 2ch area: for example, a thin section bone algorithm to look for skull base fractures with the use of reformatted images where appropriate.0A candidateEbook FRCR 2B Viva-A case-based approach: Part 2
who demonstrates a systematic approach based on everyday experience will always reassure the examiner. When practising cases, try to review on “hard 4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora Ebook FRCR 2B Viva-A case-based approach: Part 2However, the Royal College of Radiologists (RCR) has suggested that eventually rhe examination will be conducted with digital images and hard copy films will no longer be shown.Approach to a Mass Lesiono Age of the patient—as this alters the differential diagnosis•Anatomical location—Whore is rhe ce Ebook FRCR 2B Viva-A case-based approach: Part 2ntre of the lesion? Is it intra- or extra-axial?•Extent of disease-Is it solitary or multifocal?•Distribution-Are they related to the greywhite matterEbook FRCR 2B Viva-A case-based approach: Part 2
junction? Do they follow a vascular territory? Does the lesion cross the midline?4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neurora4. Introduction to Neurological ImagingAarti Shah and Nagachandar KandasamyAnecdotal experience suggests that all candidates will bo tested on neuroraGọi ngay
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