1. The document provides an overview of normal brain structures and appearances on non-contrast CT scans. It describes the margins between different tissues and structures like the cortex, subcortical white matter, and basal ganglia.
2. Guidelines are given for systematically analyzing CT brain scans, including assessing anatomical landmarks, symmetry, tissue densities, lesions, and contrast enhancement patterns. Specific abnormalities like subdural hematomas, cerebral infarctions, infections, and tumors are discussed.
3. Images demonstrate examples of normal variations and various pathologies visible on CT scans, such as herniations, hydrocephalus, edema, calcifications, and vascular abnormalities.
1. The document provides an overview of normal brain structures and appearances on non-contrast CT scans. It describes the margins between different tissues and structures like the cortex, subcortical white matter, and basal ganglia.
2. Guidelines are given for systematically analyzing CT brain scans, including assessing anatomical landmarks, symmetry, tissue densities, lesions, and contrast enhancement patterns. Specific abnormalities like subdural hematomas, cerebral infarctions, infections, and tumors are discussed.
3. Images demonstrate examples of normal variations and various pathologies visible on CT scans, such as herniations, hydrocephalus, edema, calcifications, and vascular abnormalities.
1. The document provides an overview of normal brain structures and appearances on non-contrast CT scans. It describes the margins between different tissues and structures like the cortex, subcortical white matter, and basal ganglia.
2. Guidelines are given for systematically analyzing CT brain scans, including assessing anatomical landmarks, symmetry, tissue densities, lesions, and contrast enhancement patterns. Specific abnormalities like subdural hematomas, cerebral infarctions, infections, and tumors are discussed.
3. Images demonstrate examples of normal variations and various pathologies visible on CT scans, such as herniations, hydrocephalus, edema, calcifications, and vascular abnormalities.
1. The document provides an overview of normal brain structures and appearances on non-contrast CT scans. It describes the margins between different tissues and structures like the cortex, subcortical white matter, and basal ganglia.
2. Guidelines are given for systematically analyzing CT brain scans, including assessing anatomical landmarks, symmetry, tissue densities, lesions, and contrast enhancement patterns. Specific abnormalities like subdural hematomas, cerebral infarctions, infections, and tumors are discussed.
3. Images demonstrate examples of normal variations and various pathologies visible on CT scans, such as herniations, hydrocephalus, edema, calcifications, and vascular abnormalities.
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Easy CT brain
PIYAWAN CHIEWTHANAKUL
Brain window
Bone window
Noncontrast CT
contrast CT
Normal structures on nenhanced CT (section through basal ganglia):
1, Falx cerebri; 1 2, margin between cortex and subcortical white matter; 2 3, internal capsule (anterior limb); 4, external capsule; 3 5, calcification of inner pallidum; 4 6, internal capsule (posterior limb); 5 7, straight sinus; 6 8, frontal cortex; 9, frontal subcortical white matter; 10, head of the caudate nucleus; 11, insular cortex; 7 12, putamen; 13, thalamus; 14 trigone 15, occipital cortex.
8 9
10 11 12 13 14 15
Systemic analysis of CT brain
Anatomical landmarks Symmetry
Brain structures, CSF space, calcifications
Midline structures: falx, 3&4 ventricles
Brain tissue Density: gray matter = cortex + BG white matter = subcortical Gray-white interface: = cytotoxic edema (ischemia) = vasogenic edema (tumors, abscess) Lesions: intraaxial or extraaxial density - edema (cytotoxic, vasogenic) density blood, calcification (BG) distortion of brain tissue (mass effect or volume loss) contrast CSF spaces Enhancing lesions tumor, abscess, granulomatous lesion Ventricles, cisterns, cortical sulci & fissures Ventricular enlargement atrophy, hydrocephalus density - blood, calcification (choroids plexus) density air (open skull fracture)
Systemic analysis of CT brain
Subdural window Epidural window Bone window Extraaxial blood collection adjacent to skull Crescent shape Not cross dural attachment (falx cerebri) Lentiform usually combine skull fracture Skull fractures, orbits, sinus, mastoid air sinus
SAH High density fluid collection in sulci, cistern Look for fracture , combine brain injury Aneurysm
CT brain
Hypertensive ICH
Cerebral infarction
CT brain
CT brain
ACA infarction
ICA infarction
CT brain
CT brain
Normal lateral ventricle
Compressed lateral ventricle (mass effect)
CT brain
CT brain
Lacunar infarction
Encephalomalacia
Cerebral venous infarction
right transverse sinus thrombosis
Non-enhanced axial CT increased density within the right transverse sinus (arrow), consistent with thrombus
Empty delta sign
Venous hemorrhage
Venous sinus thrombosis
Infections
Tuberculous meningitis A postcontrast CT study shows marked enhancement of the basal cisterns with ventricular dilatation indicative of communicating hydrocephalus. areas of low density in the right thalamus, right internal capsule, and left lentiform nuclei (B), representing lacunar infarcts from the vascular compromise in this meningovascular disease process.
Cerebritis
ring-enhancing lesion
a thin, well-defined, ring-enhancing lesion adjacent to the left trigone with surrounding vasogenic edema, producing mass effect and ventricular compression.
Cysticercosis with lesions in multiple stages unenhanced CT : multiple, well-defined lesions of very low density, having central high-density foci.= vesicular stage and scolices. Other nodular lesions have high density= nodular stage, and are undergoing mineralization. A few punctuate lesions of very high density = involuted calcific stage. A number of the low-density ring lesions enhance (B), representing the inflammatory reaction to the dying parasites in the colloidal stage, and the enhancement of those in the nodular stage. Note the enhancing lesion in the right occipital soft tissues.
Brain abscess
CNS TUBERCULOMA
CNS TUBERCULOMA
TUBERCULOSIS BRAIN ABSCESS
Brain abscess
Cerebral toxoplasmosis
CNS lymphoma
Encephalomalacia
Brain metastasis Multiple , at corticomedullary junction Hypo or hyperdense Hypodense : kidney, lung, breast, H&N Hyperdense : GI, choriocarcinoma,melanoma, hematologic malignancy Surrounding vasogenic brain edema CECT : nodular or thick& irregular ring enhancement
Meningeal lymphoma bilateral nodular meningeal enhancement in the occipital regions.
