Brain Imaging: A Guide for Clinicians

Paperback | March 17, 2015

byPaul C. Lebby

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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 topicsimportant 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 usegiven 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'sability 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 imageplanes 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-codedreference 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: AGuide 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 toprovide general information required when interpreting brain images.

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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 topicsimportant to those using brain imaging, suc...

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 t...
Format:PaperbackDimensions:432 pages, 10.91 × 8.5 × 0.79 inPublished:March 17, 2015Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0190239069

ISBN - 13:9780190239060

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Table of Contents

PrefaceAcknowledgmentsIntroduction1. THE CLINICAL APPLICATION OF BRAIN IMAGINGAccess to Brain ImagingAdvantages of Using Brain Imaging in the ClinicClues Regarding Extent of InjuryClues Regarding Type of InjuryClues to Location of Injury or PathologyClues Regarding Prognosis and Expected Functional OutcomeClues Regarding Time Course for RecoveryConcrete Information for FamiliesLimitations: What Neuroimaging Often Does Not Provide the ClinicianBrain imaging does not measure a patient's functioningBrain imaging may not provide information about electrochemical processesBrain imaging does not provide direct visualization of microscopic injuryBrain scans often do not provide information regarding the etiology of damageBrain scans do not treat the patientShowing Damage on Brain Images May Not be RecommendedWhat to Do When the Patient or Family Members Ask to See the Brain ScansWhat to Request When Writing Orders for Brain ImagingRadiologist ReportsAnatomy versus Functioning2. VIEWING AND INTERPRETING BRAIN SCANSOrientation and Image PlaneAxial or Horizontal OrientationAxial Reformatting with Varying Slice AnglesCoronal OrientationSagittal OrientationWhen Right Is Left and Left Is RightBasic Clinical InterpretationAppearance of Brain Tissue on Different Types of Brain ScansInterpreting Findings on a Variety of ScansUse several image types or sequences when assessing for pathologyKnow what to look for, but also be conservative in your interpretationSymmetry as a Guide to Interpreting Brain ScansEvaluating Head Position in the ScannerExercise caution when using symmetry as a guideVentricular Dilation and CompressionHow much ventricular dilation can a person sustain without symptoms?Obstructive (Noncommunicating) HydrocephalusCommunicating HydrocephalusNormal-Pressure Hydrocephalus(Hydrocephalus ex vacuo)Transependymal EdemaVentricular AsymmetrySteroid UseGuide to General Appearance of Different Tissues on Brain ImagesDevelopmental Changes Evident on NeuroimagingMyelinationTemporal Eff ects on Appearance of Brain ScansUse caution when assessing atrophyTemporal Effects due to Progression of an IllnessKnow what the imaging should look like before viewing itDiagnostic Pitfalls of NeuroimagingBeing too Focused or Not Focused EnoughMissing What Is MissingMissing Pathology in the Neutral GrayStop Searching After Finding an Obvious AbnormalityConsider All Possible Causes for a Particular "Pathological" AppearancePitfalls of Knowing the Neuropathology and Anatomy of the InjuryQuality of Brain ImagingDICOM ViewersComparing Scans Acquired on Different OccasionsPresentation of Simultaneous Images3. IMAGING-BASED NEUROANATOMYPrimary Anatomical LandmarksVentriclesMeningeal LayersDura and Dural ReflectionsDural Venous SinusesArachnoid LayerPia MaterWhite-Matter PathwaysCentrum SemiovaleCorpus CallosumCingulumCorona RadiataInternal CapsuleOptic Tract and RadiationsBasic Anatomical Areas of the BrainForebrainTelencephalonMesencephalonMidbrainHindbrainVascular SystemInternal Carotid and Vertebral Artery Distributions to the CortexCirlce of WillisWatershed AreaAppendix 3-14. BRAIN IMAGING TECHNIQUESImage QualitySpatial ResolutionContrast ResolutionNoiseWhat Type of Scan to Use?Types of ImagingStatic Brain ImagingUltrasoundComputer Axial Tomography (CAT/CT)Angiography/Digital Subtraction Angiography (DSA)Magnetic Resonance Imaging (MRI)Hybrid Brain ImagingDiffusion-Weighted MRI (DWI)Diffusion Tensor Imaging-Fractional Anisotropy and TractographyCerebral Perfusion-Weighted MRI (PWI)Magnetic Resonance Spectroscopy (MRS)Functional Brain ImagingMagnetic Encephalopathy (MEG-MSI)General Concerns about Clinical Use of Functional Brain ImagingBenefits of Using Multiple Functional Imaging Techniques for Each Patient5. NEUROIMAGING OF TRAUMATIC BRAIN INJURIESFocal Injury, Diffuse Injury, or a Combination?Post-Traumatic HemorrhagesEpidural Hemotoma/Hemorrhage (EDH)Subdural Hematoma/Hemorrhage (SDH)Examples of Subdural Hematomas/HemorrhagesSubarachnoid Hematoma/HemorrhageExamples of Subarachnoid Hematomas/HemorrhagesIntraparenchymal HemorrhagesPetechial HemorrhagesDiff use Axonal InjuryHemorrhagic ContusionsContrecoup InjuriesCommon Locations for Hemorrhagic and Nonhemorrhagic ContusionsSubcortical HemorrhagesPost-Traumatic PneumocephalusPost-Traumatic Hypoxic Ischemic EncephalopathyLaminar Necrosis due to Hypoxic Ischemic InfarctionSecond-Impact SyndromeIntraventricular HemorrhagesPost-Traumatic VasospasmIntracerebral EdemaMidline Shift and Asymmetrical Compression the of VentriclesMidline Shift and Asymmetrical Compression the of Ventricles 278 Loss of Gray-White DifferentiationBlast InjuriesImaging Changes over Time Following SevereTraumatic Brain InjuryPenetrating InjuriesPenetration by Bone or DebrisGunshot WoundsLow-Velocity Penetrating InjuriesHigh-Velocity Penetrating InjuriesShotgun InjuriesNonaccidental Trauma (NAT)Suspected Nonaccidental Trauma but Not Nonaccidental Trauma6. NONTRAUMATIC BRAIN INJURIESInfections of the BrainMeningitisEncephalitis and CerebritisMeningoencephalitisAbscessEmpyemaStroke and Vascular PathologiesImaging Nontraumatic Hemorrhagic Strokes-Cerebral Vascular Accident (CVA)Hemorrhagic CavernomasBleeding Disorders Resulting in Spontaneous HemorrhageNonhemorrhagic and Embolic Ischemic StrokesBlockage of Venous FlowLoss of Internal Carotid Flow Without Stroke-Related SymptomsDiffuse Hypoxic EncephalopathyWatershed InfarctionsWhite-Matter DisordersMultiple Sclerosis (MS)Acute Disseminated Encephalomyalitis (ADEM)Toxic Damage to White MatterNeoplasmDiffuse, Infiltrating, and Nonenhancing TumorDiffuse, Infiltrating, and Contrast-Enhancing TumorEncapsulated Nonenhancing Cystic TumorEncapsulated Contrast-Enhancing TumorHydrocephalus due to Tumor GrowthNeurodevelopmental DisordersCortical DysplasiaAgenesis of the Corpus Callosum (ACC)PolymicrogyriaAnencephalyHoloprosencephalySchizencephalyMultiple Neurodevelopmental ConditionsParasitic Disorders7. BRAIN ATLASIndexIndex of Clinical Examples

Editorial Reviews

"This well written and eminently readable book fills the gap between the student or practitioner with a rudimentary understanding of brain imaging techniques and the complex knowledge required by specialists. Rather than over simplify, the book focuses on what is necessary to understand thesetechniques in the context of clinical usefulness. ... This book provides the reader with the ability to understand the usefulness and limitations of brain imaging so that studies may be ordered appropriately with a clinical question in mind and not just as an indiscriminate screening tool." --H. Terry Hutchison, M.D., Ph.D., University of California, San Francisco - School of Medicine