OXFORD UNIVERSITY PRESS

Brain Imaging: A Guide for Clinicians

ISBN : 9780190239060

Price(incl.tax): 
¥15,876
Author: 
Paul C. Lebby
Pages
432 Pages
Format
Paperback
Size
217 x 279 mm
Pub date
May 2015
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Brain Imaging: A Guide for Clinicians is designed to provide a foundation of information necessary for those wishing to integrate brain imaging into their practice, or to those who currently review brain scans but have minimal formal training in neuroimaging. The guide covers a range of topics important to those using brain imaging, such as the strengths and weaknesses of the many different techniques currently available, the factors that may influence the use of imaging data, common pitfalls or artifacts that may be misleading to the clinician, the most appropriate techniques to use given a specific clinical question or condition, how to interpret information presented on a brain image, and also how many pathological conditions appear on a variety of brain scanning techniques or sequences. This guide also provides detailed information regarding the identification of primary brain regions, anatomical structures, systems or pathways using both two-dimensional and three-dimensional imaging techniques. A brain atlas is included using both CT and MRI sequences to facilitate the reader's ability to identify most primary brain structures. A novel color-coded system is used throughout this guide to assist the reader in identifying slice locations and orientations. Images with green borders are displayed in the axial plane, with the slice location being shown on other orthogonal image planes by a green line. Similarly, images with a red border are displayed in the coronal plane and those with a blue border are displayed using a sagittal plane; red and blue reference lines are displayed on orthogonal slices to identify the slice location. The crosshairs formed by the color-coded reference lines optimize the reader's ability to identify primary anatomical structures or pathological markers and processes. Chapters in this book progress from a general description of the clinical use of brain images and the interpretation of scans, to more complex material involving neuroanatomy and imaging technology. Real-life examples of clinical cases are integrated into all chapters of this guide. Brain Imaging: A Guide for Clinicians features hundreds of images derived from traumatic and non-traumatic pathologies to provide the reader with examples of conditions most often seen in the clinic. PEARL-PERIL sections outline critical information for the clinician, along with many tables and charts designed to provide general information required when interpreting brain images.

Index: 

Preface
Acknowledgments
Introduction
1: THE CLINICAL APPLICATION OF BRAIN IMAGING
Access to Brain Imaging
Advantages of Using Brain Imaging in the Clinic
Clues Regarding Extent of Injury
Clues Regarding Type of Injury
Clues to Location of Injury or Pathology
Clues Regarding Prognosis and Expected Functional Outcome
Clues Regarding Time Course for Recovery
Concrete Information for Families
Limitations: What Neuroimaging Often Does Not Provide the Clinician
Brain imaging does not measure a patient's functioning
Brain imaging may not provide information about electrochemical processes
Brain imaging does not provide direct visualization of microscopic injury
Brain scans often do not provide information regarding the etiology of damage
Brain scans do not treat the patient
Showing Damage on Brain Images May Not be Recommended
What to Do When the Patient or Family Members Ask to See the Brain Scans
What to Request When Writing Orders for Brain Imaging
Radiologist Reports
Anatomy versus Functioning
2: VIEWING AND INTERPRETING BRAIN SCANS
Orientation and Image Plane
Axial or Horizontal Orientation
Axial Reformatting with Varying Slice Angles
Coronal Orientation
Sagittal Orientation
When Right Is Left and Left Is Right
Basic Clinical Interpretation
Appearance of Brain Tissue on Different Types of Brain Scans
Interpreting Findings on a Variety of Scans
Use several image types or sequences when assessing for pathology
Know what to look for, but also be conservative in your interpretation
Symmetry as a Guide to Interpreting Brain Scans
Evaluating Head Position in the Scanner
Exercise caution when using symmetry as a guide
Ventricular Dilation and Compression
How much ventricular dilation can a person sustain without symptoms?
Obstructive (Noncommunicating) Hydrocephalus
Communicating Hydrocephalus
Normal-Pressure Hydrocephalus
(Hydrocephalus ex vacuo)
Transependymal Edema
Ventricular Asymmetry
Steroid Use
Guide to General Appearance of Different Tissues on Brain Images
Developmental Changes Evident on Neuroimaging
Myelination
Temporal Eff ects on Appearance of Brain Scans
Use caution when assessing atrophy
Temporal Eff ects due to Progression of an Illness
Know what the imaging should look like before viewing it
Diagnostic Pitfalls of Neuroimaging
Being too Focused or Not Focused Enough
Missing What Is Missing
Missing Pathology in the Neutral Gray
Stop Searching After Finding an Obvious Abnormality
Consider All Possible Causes for a Particular "Pathological" Appearance
Pitfalls of Knowing the Neuropathology and Anatomy of the Injury
Quality of Brain Imaging
DICOM Viewers
Comparing Scans Acquired on Different Occasions
Presentation of Simultaneous Images
3: IMAGING-BASED NEUROANATOMY
Primary Anatomical Landmarks
Ventricles
Meningeal Layers
Dura and Dural Reflections (Folds)
Dural Venous Sinuses
Arachnoid Layer
Pia Mater
White-Matter Pathways
Centrum Semiovale
Corpus Callosum
Cingulum
Corona Radiata
Internal Capsule
Optic Tract and Radiations
Basic Anatomical Areas of the Brain
Forebrain
Telencephalon
Mesencephalon
Midbrain
Hindbrain
Vascular System
Internal Carotid and Vertebral Artery Distributions to the Cortex
Circle of Willis
Watershed Area
Appendix 3-1
4: BRAIN IMAGING TECHNIQUES
Image Quality
Spatial Resolution
Contrast Resolution
Noise
What Type of Scan to Use?
Types of Imaging
Static Brain Imaging
Ultrasound
Computer Axial Tomography (CAT/CT)
Angiography/Digital Subtraction Angiography (DSA)
Magnetic Resonance Imaging (MRI)
Hybrid Brain Imaging
Diffusion-Weighted MRI (DWI)
Diffusion Tensor Imaging-Fractional Anisotropy and Tractography
Cerebral Perfusion-Weighted MRI (PWI)
Magnetic Resonance Spectroscopy (MRS)
Functional Brain Imaging
Positron Emission Tomography (PET)
Combined Positron Emission Tomography and CT (PET-CT) or MRI (PET-MRI)
Single-Photon Emission Computed Tomography (SPECT)
Functional Magnetic Resonance Imaging (fMRI)
Magnetic Encephalopathy (MEG-MSI)
General Concerns about Clinical Use of Functional Brain Imaging
Benefits of Using Multiple Functional Imaging Techniques for Each Patient
5: NEUROIMAGING OF TRAUMATIC BRAIN INJURIES
Focal Injury, Diffuse Injury, or a Combination?
Post-Traumatic Hemorrhages
Epidural Hemotoma/Hemorrhage (EDH)
Subdural Hematoma/Hemorrhage (SDH)
Examples of Subdural Hematomas/Hemorrhages
Subarachnoid Hematoma/Hemorrhage
Examples of Subarachnoid Hematomas/Hemorrhages
Intraparenchymal Hemorrhages
Petechial Hemorrhages
Diff use Axonal Injury
Hemorrhagic Contusions
Contrecoup Injuries
Common Locations for Hemorrhagic and Nonhemorrhagic Contusions
Subcortical Hemorrhages
Post-Traumatic Pneumocephalus
Post-Traumatic Hypoxic Ischemic Encephalopathy
Laminar Necrosis due to Hypoxic Ischemic Infarction
Second-Impact Syndrome
Intraventricular Hemorrhages
Post-Traumatic Vasospasm
Intracerebral Edema
Midline Shift and Asymmetrical Compression the of Ventricles
Loss of Gray-White Differentiation
Blast Injuries
Imaging Changes over Time Following SevereTraumatic Brain Injury
Penetrating Injuries
Penetration by Bone or Debris
Gunshot Wounds
Low-Velocity Penetrating Injuries
High-Velocity Penetrating Injuries
Shotgun Injuries
Nonaccidental Trauma (NAT)
Suspected Nonaccidental Trauma but Not Nonaccidental Trauma
6: NONTRAUMATIC BRAIN INJURIES
Infections of the Brain
Meningitis
Encephalitis and Cerebritis
Meningoencephalitis
Abscess
Empyema
Stroke and Vascular Pathologies
Imaging Nontraumatic Hemorrhagic Strokes-Cerebral Vascular Accident (CVA)
Hemorrhagic Cavernomas
Bleeding Disorders Resulting in Spontaneous Hemorrhage
Nonhemorrhagic and Embolic Ischemic Strokes
Blockage of Venous Flow
Loss of Internal Carotid Flow Without Stroke-Related Symptoms
Diffuse Hypoxic Encephalopathy
Watershed Infarctions
White-Matter Disorders
Multiple Sclerosis (MS)
Acute Disseminated Encephalomyalitis (ADEM)
Toxic Damage to White Matter
Neoplasm
Diffuse, Infiltrating, and Nonenhancing Tumor
Diffuse, Infiltrating, and Contrast-Enhancing Tumor
Encapsulated Nonenhancing Cystic Tumor
Encapsulated Contrast-Enhancing Tumor
Hydrocephalus due to Tumor Growth
Neurodevelopmental Disorders
Cortical Dysplasia
Agenesis of the Corpus Callosum (ACC)
Polymicrogyria
Anencephaly
Holoprosencephaly
Schizencephaly
Multiple Neurodevelopmental Conditions
Parasitic Disorders
7: BRAIN ATLAS
Index
Index of Clinical Examples

About the author: 

Paul C. Lebby has over 20 years of experience in integrating brain imaging into his clinical practice, beginning with the interpretation of images on sheets of film and progressing to current high-tech procedures. He has a background in computer graphics, which he has used to facilitate his teaching of neuroanatomy and neuropathology to students for more than two decades. He lectures across the country on the clinical use of brain imaging for those who treat patients with central nervous system conditions.

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