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ANATOMICAL AREAS OF CEREBRAL HEMISPHERES ITS CLINICAL AND RADIOLOGICAL SIGNIFICANCE BY DR. K.SRINIVASA MUDALI PROF.& HOD.RADIOLOGY DEPT SRM MEDICAL COLLEGE XRAY SKULL XRAYS WILL NOT REVEAL ANATOMICAL DETAILS OF BRAIN BONY LAND MARKS BONE EROSIONS SUTURAL DIASTSIS CEREBRAL ANGIOGRAPHY PNEUMO ENCHEPHLOGRAM SOFT TISSUE CALCIFICATIONS WERE HELPFUL IN LOCALISING DISEASED AREA CT SCAN DEFFICIENT IN WHITE MATTER DETAILS MRI SCAN BETTER VISULISATION OF WHITE MATTER DETAILS CEREBRAL BLOOD VOLUME VASCULLAR DETAILS WITH CONTRAST ONLY NERVES AND NERVE FIBRES NOT VISUALISED BETTER DELIENIATION OF BONE DETAILS O2 LEVEL IN BLOOD MOVEMENT OF WATER MOLECULES NERVE AND NERVE TRACTS T1 WEIGHTED IMAGES TISSUES WITH SHORT T1 APPEAR WHITE TISSUES WITH LONG TI APPEARS BLACK BRIGHT DARK CSF FAT CALCIFICATION METHHAEMOGLOBIN HAEMOSIDERIN WHITE MATTER BONE DURA MATTER T2 WEIGHTED IMAGES BRIGHT CSF DARK HAEMOSIDERIN PATHOLOGICAL LESIONS MENINGIOMAS BASAL GANGLIA CALCIFICATIONS DURA MATTER LIGAMENTS GRAY MATTER WHITE MATTER NEONATES HYPER INTENSE ON T1 HYPERTENSE ON T2 PREMATURE HYPERINTENSE IN T1 HYPER INTENSE IN T2 ADULTS HYPERINTENSE ON T2 HYPERINTENSE ON T1 CHILD BRAIN NO IRON DEPOSITION IN NEW BORN WHITE MATTER AND GREY MATTER DETAILS NOT CLEAR SULCI WILL NOT BE PROMINENT BRAIN IN OLD AGE IRON DEPOSITION AGE RELATED BRAIN VOLUME REDUCED WIDENING OF FISSURES DILATED VENTRICLES INCREASED CORTICAL SULCI DURA MATTER MRI IS BETTER THAN CT SCAN BONE APPEARS BLACK SO DURA WILL APPEAR MORE BRIGHT SUBDURAL HAEMATOMA PELLET INJURY COURTESY FROM B.I.R INTERHEMISPHERIC SPHERE MRI SCAN T1 WEIGHTED IMAGE CT SCAN T2 WEIGTED IMAGE MENINGIOMA OVER FALX CEREBRI WITH CALCIFICATION INTER HEMISPHERIC CYST COURTESY FROM BIR SCHIZENCHEPHALY A CLEFT IN THE BRAIN THAT EXTENDS CORTEX IN TO THE VENTRICLES MENTAL RETARDATION AND SEIZURES COURTESY FROM BIR NEURO CYSTI CERCOSIS MULTIPLE VESCICLES OVER BRAIN PARENCHYMA AND OVER SOFT TISSUES MULTIPE RING ENHANCING LESIONS TUBERCULOMAS BASAL GANGLIA CENTAL SULCUS INSULA SEPTUM PELLUCIDUM CUADATE NUCLEUS INTERNAL CAPSULE PUTAMEN THALAMUS PARIETO OCCIPITAL SULCUS SUPERIOR SAGITTAL SINUS BILATERAL BASAL GANGLIA CALCIFICATION OSMOTIC ENCHEPHALOPATHY BILATERAL HYPO DENSE LESIONS OVER THALAMI BILATERAL HYPER INTENSE LESIONS OVER THALAMI DIFFUSE AXONAL INJURY OBSTRUCTIVE HYDROCHEPHALUS DUE TO MASS OVER 4TH VENRICLE CONGENITAL NARROWING AND DILATATION OF OCCIPITAL HORN OF RT LATERAL VENTRICLE OBSTRUCTIVE HYDROCEPHALUS DUE TO AQUIDUCTAL STENOSIS SPHENOIDAL SINUS OPTIC. N. CEREBELLOPONTINE CISTERN ICA.LT INT.JUGULAR.V. BASILAR.A 4TH .VENTRICLE VERMIS CONFLUENCE OF SINUSES STRAIGHT GYRUS VISUAL CORTEX M.CEREBRAL A. QUADRIGEMINAL CISTERN LATERAL VENTRICLE INSULA 3RD VENTRICLE HIPPOCAMPUS REDNU CLEUS CORPUS CALLOSUM CAUDATE NUCLEUS TENTORIUM CEREBELLI CINGULATE GYRUS THALAMUS LATERAL VENTRICLE 4TH VENTRICLE 3RD VENTRICLE MULTIPLE SCLEROSIS HYPER DENSE LESIONS OVER PERIVENTRICULAR REGIONS CORPUS CALLOSAL AGENESIS Cavum velum interpositium interpositium HYPER INTENSE ON T2 HYPO INTENSE ON T1 CHRONIC INTRA CEREBRAL HAEMATOMA THROMBUS OVER LT INTERNAL CAROTID ARTERY Internal carotid artery LT LT COMMON CAROTID ARTERY ANUERYSM WITH THROMBUS MR ANGIO ANUERYSM OVER INTERNAL CAROTID ARTERY GIANT ANUERYSM A,COMM.A. A.CEREBRAL.A, POST.COM.A. ICA. IN CAROTID CANAL MCA BASILAR .A. AVM OVER PAREITO OCCIPITAL LOBE RT SIDE T1 WEIGHTED IMAGE GRADIENT ECHO DIFFUSION WEIGHTED IMAGE MR ANGIOGRAM MR VENOGRAM Superior sagittal sinus Cerebral veins dont have valves Straight sinus Blood flow possible in all directions S.s. sinus receives blood From diploic veins and emissary veins Also contains arachnoid villai hence Absorbs csf . Transverse sinus VENOUS MALFORMATION LT PAREITAL LOBE Diffusion weighted image Mr venogram VENOUS INFARCT NEAR LT THALAMIC REGION CT PERFUSION CBV MAP SHOWS MEAN TRANSIT TIME MAP AREA OF LOW CBV LOW CBV AND CBF DEAD TISSUE PROLONGED MTT NORMAL CBF SALVAGABLE ISCHAEMIC TISSUE MR SPECTROSCOPY TUMOURS N ALLYLNASPERTATE INDICATES NUERONAL NAA CR TOTAL CHOLINE PROCESS WHEN NUERONS DIE LACTATE IS PRODUCT OF ANAEROBIC METABOLISM HYPOXIA LACTATE LIPIDS STROKE NAA CR LACTATE GLX BOLD Analysis (fMRI) to map (dys)functional brain area's preoperative mapping of cortex language lateralization/evaluation of brain Applications dominance study of functional recovery Bilateral finger tapping / rest Motor cortex, displaced to the front on the right size, due to the presence of a parietal glioblastoma multiforme Patient revealed to be operable with excellent neurologic status postoperatively DIFFUSION TENSOR IMAGING DIFFUSION OF WATER IN ANISOTROPIC TISSUE Fibertracking: Cortico‐spinal tract Part of the corticospinal tract originating from the ‘foot’ SM1 area runs medially at the level the corona radiata, and posterior at the level of the capsula interna, in relation to the fibers originating from the ‘hand’ SM1 area IMAGES FROM DEPT.OF RADIOLOGY SRM MEDICAL COLLEGE & HOSPITAL B.I.R.MADRAS MEDICAL COLLEGE G.E. MEDICAL EQUIPMENT DIVISION THANK YOU
