Radiology of CVDz
Terms
undefined, object
copy deck
- What is the mortality associated with Subarachnoid hemmorhage?
- 50%
- What are the various forms of annuerysm?
- saccular, fusiform (do not cause SAH), and dissecting
- What is imaging is indicated for Subarachnoid hemmorhage?
- Computerized Tomography, catheter angiography is needed to pinpoint the exact location.
- What is DWI?
- Diffusion weighted imaging, a variation of MRI capable of detecting cerebral infarction within two hours of stroke onset.
- True or False? CT is good at detecting acute infarction.
- False. CT is incapable of detecting before 12 hours and frequently not reliably before 18 hours.
- What image study is indicated for brainstem/cerebellum...the posterior fossa?
- MRI due to the absence of bone artifact.
- What is the surgical treatment for carotid artery stenosis?
- (CEA) Carotid Endarterectomy
- How do AVM (arteriovenous malformations) typically present?
- Seizure or hemorrhage, usually idiopathic but may present with Rendu-Osler-Weber or Wyburn-Mason Syndromes.
- What is CTA?
- CT Angiogram imaging technique utilizing helical CT and IV contrast to generate CT generated images. Everyone suspected of stroke gets CTA!!!!!!!
- What is the gold standard for evaluation of carotid arteries?
- Ultrasonography.
- In what capacities does CT exceed MRI?
-
Evaluation of
1. SAH, calcification
2. fractures
3. High resolution of the temporal bones
CT has no contraindications save pregnancy - What are the disadvantages associated with CT?
- Stroke will invariably be negative for up to 18 hours (hemorrahge can be detected almost immediately)
- What is the FDA approved critical time for administration of tissue plasminogen activator?
- 3 hours for IV tPA, 6 hours for (IA) tPA intrarterial using a microcatheter inserted into the femoral A and routed to the site of stenosis.
- What are some major setbacks associated with MRI DWI?
- It is slow (45 min) and usually makes monitoring the patient very difficult. No annuerysm clips/coils, no pacemakers or other ferromagnetics.
- Define cytotoxic edema?
- Cell death associated with infarction in the cortex, grey matter and nuclei.
- Define vasogenic edema.
- Associated with stroke in the grey matter (white is spared) secondary to tumor or infection.
- Discuss the contrasts utilized to enhance CT & MRI images.
- CTI vs MRIGood! CT gets Iodine which is nephrotoxic. MRI is enhanced with Gadollinium.
- What are some common etiologies of stroke.
- Artery disease. Heart is a common source of emboli (PFO, mitral valve stenosis), carotid arteries also embolize, systemic DZ (HTN) and hematopathy (bad platelets)