NOTES FOR NEUROIMAGING:

Introduction to medical imaging and common neurodevelopmental

anomalies)

WILHELM ROENTGEN – 1895 DISCOVERED X-RAY

DIAGNOSTIC RADIOLOGIST - Medical Doctor that interprets images obtained from variety
of imaging modalities and techniques inorder to diagnose Diseases

RADIOLOGIC TECHNOLOGIST - Medical professional that performs imaging examinations

and procedures ensuring that quality diagnostic image is produced.

RADIOLOGY NURSE - Focuses and cares for patients that are preparing for and during their
imaging procedures. Also referred to as Medical imaging nurses

FILM BADGE DOSIMETER - Personal dosimeter used for monitoring

cumulative radiation dose due to ionizing radiation. The badge consists of two parts:
photographic film, and a holder.

DIAGNOSTIC X-RAY - X rays are electromagnetic radiation that differentially penetrates

structures within the body and creates images of these structures on photographic film or a
fluorescent screen
FLUOROSCOPY -Continuous beam of x-rays to cast image on fluorescing screen, which is
amplified by an electronic image intensifier and viewed on a high resolution television screen.
DIAGNOSTIC ULTRASOUND - Sonography or diagnostic medical sonography, is an imaging
method that uses sound waves to produce images of structures within the body.
COMPUTED TOMOGRAPHY - Introduced in 1970’s in which a three-dimensional image of a
body structure is constructed by computer from a series of plane cross-sectional images made
along an axis

• Uses Gantry with rotating x-ray beam and multiple detectors in various arrays
• two dimensional datas are processed by sophisticated computer algorithms producing
formatted images in mulitplanar planes in diagnostic quality
• Cornerstone of cross sectional imaging
MAGNETIC RESONANCE IMAGING -

A technique that uses a magnetic field and radio waves to create detailed images of the organs
and tissues within the body.

• Uses very strong magnetic fields and radiofrequency pulses to manipulate atoms
(hydrogen atoms) and allow highly sophisticated computer programs to produce two to
three dimensional images

• Uses no ionizing radiation

• Sensitive study of soft tissues such as muscles, ligaments and tendons

• Two types: open and close

POSITRON EMMISION TOOGRAPHY SCAN - An imaging test that helps reveal how your
tissues and organs are functioning. Uses a radioactive drug (tracer) to show this activity
PET CT-SCAN - A PET - CT scan combines a CT scan and a PET scan. It gives detailed
information about the anatomy and activity of lesions in cases of cancer.

AS LOW AS REASONABLY ACHIEVABLE” (ALARA)

Highest quality image using lowest possible radiation dose

DICTATES RADIODENSITY – THICKNESS AND COMPOSITION

FATE OF XRAY PHOTON AS IT TRAVERSES MATTER -

Transmitted or Not transmitted (absorbed or deflected/scattered)

There is a metallic silver component in the X-ray film that are precipitated to produce blackening
of areas when interacted with x-ray photon

RADIOGRAPHIC PROJECTION AND VIEW:

The path taken by an x-ray beam as it passes through the body
e.g. Anteroposterior Projection, refers to a beam that enters the anterior (front) of the body and
exits the posterior (back).
Posterioranterior Projection, refers to a beam that enters the posterior (back) of the body and
exits the anterior (front).
X-ray beam from source like light is DIVERGENT

• The body image in a certain position as seen by the image receptor of a radiographic
imaging system. It is the opposite of the radiographic projection.
 • IMAGE- Any type of rendering of any radiologic examination
• STUDY OR EXAMINATION – Collection of images used to examine a particular
part of the body or system
• CONTRAST MATERIAL (CONTRAST AGENT) – substance that is administered to
the patient to make certain structures more easily visible

• Patient’s right side is always on your left side when you are looking at any image

• En face – facing forward

• In profile – as seen from the side

MODALITY WHITE BLACK

Conventional
radiography
Radiodense/radioopaque Radiolucent
CT-scan High attenuating/hyperdense Low
attenuating/hypoden
se
MRI Bright/hyperintense/high signal Dark/hypointense/Lo
w signal
Ultrasound Hyperechoic/increased
echogenicity
Hypoechoic/Decreas
ed echogenicity

Nuclear Medicine Increased tracer uptake Decreased tracer uptake

Please do further readings

• Learning Radiology (Recognizing the Basics) by

William Herring MD
 • Squire’s Fundamentals of Radiology by Robert A.
Novelline M.D.

PRIMARY NEURULATION:

Notochordal process
prechordal plate induce development of neural plate
 Lateral portions of neural plate thicken, fold
 Neural folds bend medially towards each other
 Neural folds fuse
 neural crest cells detach from lateral lips of neural folds and migrate laterally

 Neural tube closes bidirectionally in "zipper-like“ fashion

 Surface ectoderm fuses, neural tube separates and sinks into mesenchyme of posterior
body wall

Neural tube bends, forms primary, then secondary vesicles

Prosencephalon (forebrain) gives rise to telencephalon, diencephalon
Mesencephalon gives rise to midbrain
Rhombencephalon (hindbrain) gives rise to developing pons, cerebellum, medulla
Cerebral hemispheres, ventricles develop as diverticulae from lateral walls of forebrain, expand
rapidly to cover diencephalon

Proliferating cells around ventricles form germinal zones of neuroblasts

Neuroblasts migrate peripherally in waves, creating cortex in an "inside-out" sequence from deep
to superficial layer
Commissural tracts (anterior, hippocampal,corpus callosum) form at cranial end of telencephalon
Corpus callosum undergoes bidirectional thickening; anterior portion of genu, posterior callosal
body form"'rostrum forms last (after splenium)

Diencephalic alar plate forms thalamus,hypothalamus; roof plate and ependyma form choroid
plexus, circumventricular organs
Primitive mesenchymal tissue ("leptomeninx") differentiates into arachnoid, pia; arachnoid space
is created as mesenchumal tissue between arachnoid, pia is resorbed leaving scattered
arachnoidal trabeculae or struts

SECONDARY NEURULATION:

Mesodermal cells in caudal eminence (tail mass) fuse

Vacuoles in tail mass form, fuse ~ hollow tube
Lumen of caudal eminence fuses/becomes continuous with neural tube Caudalmost part of neural
tube eventually regresses, forming filum terminale

.
Cause Effect

Failure of part of NEURAL Neural tube defects ranging from simple spina bifida to
TUBE CLOSURE myelomeningocoele,
Defective development of Defects ranging from mild anomalies of olfactory bulbs to alobar
VENTRO-MEDIAL holoprosencephaly
FOREBRAIN
Faulty NEURONAL Lissencephaly, subcortical band heterotopia, etc.
MIGRATION
Failure of normal Corpus callosum anomalies
COMMISURAL
DEVELOPMENT
Mal-differentiation of Lipoma
primitive LEPTOMENINX

If interested you may look at RADIOPAEDIA.ORG the example cases mentioned in the table