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    Basic Interpretation of CT Scan: Hon-Man Liu 廖漢文

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    CT scans provide information by analyzing the density of structures. A basic interpretation involves a pre-contrast study to examine hypo-, hyper-, and iso-densities, followed by a post-contrast study to identify enhancement patterns. Changes in adjacent structures like edema, bones, and CSF spaces also provide clues. Clinical information helps determine if findings are acute, progressive, or stable. Radiologists must consider multiple factors like biological characteristics and disease timelines to accurately diagnose conditions shown on CT scans.

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    Basic Interpretation of CT Scan: Hon-Man Liu 廖漢文

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    hanwenliao
    43 views46 pages
    CT scans provide information by analyzing the density of structures. A basic interpretation involves a pre-contrast study to examine hypo-, hyper-, and iso-densities, followed by a post-contrast study to identify enhancement patterns. Changes in adjacent structures like edema, bones, and CSF spaces also provide clues. Clinical information helps determine if findings are acute, progressive, or stable. Radiologists must consider multiple factors like biological characteristics and disease timelines to accurately diagnose conditions shown on CT scans.

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    1 Introduction of CT

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    CT scans provide information by analyzing the density of structures. A basic interpretation involves a pre-contrast study to examine hypo-, hyper-, and iso-densities, followed by a post-contrast study to identify enhancement patterns. Changes in adjacent structures like edema, bones, and CSF spaces also provide clues. Clinical information helps determine if findings are acute, progressive, or stable. Radiologists must consider multiple factors like biological characteristics and disease timelines to accurately diagnose conditions shown on CT scans.

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    43 views46 pages

    Basic Interpretation of CT Scan: Hon-Man Liu 廖漢文

    Uploaded by

    hanwenliao
    CT scans provide information by analyzing the density of structures. A basic interpretation involves a pre-contrast study to examine hypo-, hyper-, and iso-densities, followed by a post-contrast study to identify enhancement patterns. Changes in adjacent structures like edema, bones, and CSF spaces also provide clues. Clinical information helps determine if findings are acute, progressive, or stable. Radiologists must consider multiple factors like biological characteristics and disease timelines to accurately diagnose conditions shown on CT scans.

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    of 46

    Basic Interpretation of CT Scan

    Hon-Man Liu
    廖漢文
    Basic Interpretation of CT Scans
    Most of the CT pictures are non-
    specific

    CT pictures are depending on the


    density of the structures.
    Principles of CT Diagnosis

    • Pre-contrast study
    • Post-contrast study
    • Change in adjacent structures
    • Clinical Information
    • Biological or anatomical
    characteristics
    Pre-contrast study of CT
    • Hypo - density
    Comparison with CSF and brain tissue
    • Hyper - density
    Comparison with cranium bone
    • Iso - density
    As brain parenchyma
    • Hetero- density
    Hypo-density in CT

    Higher than CSF but lower than brain tissue

    tumor, abscess, resolving hematoma,


    evolution infarct,

    protein, blood, debris


    Hypo-density in CT
    Higher than CSF but lower than brain tissue
    Hypo-density in CT

    Iso-density to CSF

    chronic hematoma, chronic infarct,


    porencephaly, congenital cyst,
    encephalomalacia change

    Water-like content
    Hypo-density in CT
    Iso-density to CSF
    Hypo-density in CT
    Lower than CSF
    • fat or cholesterol
    congenital tumor: dermoid ,
    epidermoid,lipoma,
    • air
    head injury, pneumocephaly
    • myxoid
    Hypo-density in CT
    Lower than CSF
    Hyper-density in CT

    Comparison with bone


    • Iso- or higher than bone
    ossification, calcification, metallic,
    iatrogenic, blood pooling
    • Less than bone but higher than brain tissue
    hemorrhage, compacted cellularity
    Hyper-density in CT
    Iso- or higher than bone
    Hyper-density in CT
    Less than bone but higher than brain tissue
    Post-contrast CT
    Enhancement patterns
    • gyral, ribbon, cortical
    • soild
    • rim or ring
    • mural nodular
    • linear and dot
    • heterogenous
    • no enhancement
    Enhancement Patterns
    Change in Adjacent Structures in
    CT

    • Edema
    • Bone
    • Ventricles, sulci and cistern
    Edema Pattern in CT
    • Vasogenic edema
    tumors, infection, late infarct
    along the white matters, finger-like
    • Interstitial edema
    periventricular white matter, ependymitis
    granularis
    • Cytotoxic edema
    ischemia or infarct, gray matter
    Vasogenic Edema
    Vasogenic edema
    Cytotoxic Edema
    CAUSES of RAISED
    INTRACRANIAL PRESSURE

    Hydrocephalus Brain edema

    S.T.L
    Tumor,
    Hematoma,
    Cyts,
    Infarct….
    RAISED INTRACRANIAL
    PRESSURE

    DEATH

    ICP

    DAYS WEEKS HOURS

    Coning
    Focal mass effect CSF space hydrocephalus
    change Herniation
    Herniation

    Subfalcine

    Parahippocampus

    Central, tonsillar
    SUBFALCINE HERNIA
    TRANSTENTORIAL HERNIAS

    1. PARAHIPPOCAMPAL GYRUS (PHG)


    HERNIATION

    2. CENTRAL/DIENCEPHALIC
    HERNIATION

    MAY OCCUR INDEPENDENTLY OR


    IN COMBINATION
    PARAHIPPOCAMPAL GYRUS
    (PHG) HERNIATION
    COMPLICATIONS of PHG
    HERNIATION
    COMPLICATIONS of PHG
    HERNIATION

    PCA ossculsion

    3rd nerve palsy


    CENTRAL HERNIATION

    MAMILLARY BODY
    PONS
    CENTRAL HERNIATION

    NORMAL HERNIA

    AP AP
    diameter diameter
    =/< trans > trans
    diameter diameter
    SECONDARY BRAIN
    STEM
    HAEMORRHAGES

    Duret hemorrahge
    CEREBELLAR TONSILAR HERNAITION

    OR

    CONING
    Bone Change in CT

    • Foramen
    internal auditory canal, foramen ovale,
    orbital fissures
    • Cranium bone
    hyperostosis
    CSF Spaces Change in CT

    • Widening or obliterated
    • Sensitive to mass effect
    • Proportional or in-proportional
    CT of Cerebral Ischemia
    (lentiform nucleus sign)
    • Ischemia: gray matter
    increased water -- density --
    density closed to white
    matter -- loss of the
    differentiation between the
    lentiform nucleus and
    internal capsule
    CT of Cerebral Ischemia
    (Insular ribbon sign)
    Ischemia -- cytotoxic
    edema -- cellular
    swelling -- mass
    effect -- straightening
    the normal waving
    insular ribbon
    CT of Cerebral Ischemia
    (Hyper-dense vascular sign)

    • Ischemia -- blood
    stasis in great
    vessel such as M1
    -- blood clot -- high
    density
    Biological and Anatomical
    Characteristics
    • Hemangioblastoma
    hemoglobin, hematocrit, erythropoietin
    • Craniopharyngioma
    anterior 3rd ventricle to nasopharynx
    Clinical Information in CT

    • Acute, progressive or stationary


    • Timing
    important in ischemic disease
    • previous history of irradiation or
    operation

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