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1、中枢神经系统影像诊断,协和医院放射科,孔祥泉,一、Examination methods,1. X-ray plain film,This method is very simple and cheap. Some lesions can be found by it.Usually we cannot reach to an exact diagnosis only by this examination,2. Tomography,Exact diagnosis still cannot obtained,The method can manifested some osseous des
2、truction which cannot be shown by plain film.,Enhancement:,3. CT,To display tumors, hemorrhage, infarction, infection and abnormality.,To show the abnormal isodensity which cannot found by the plain scan.,To confirm the quality of the lesion.,Differential diagnosis of tumor and edema .,Plain scan:,T
3、he characters of the lesion including size, appearance, number, position , anatomy relation ,and so on can be shown by it.,4. Magnetic resonance imaging,Plain scan:,Enhancement:,To show the abnormal isodensity which cannot found by the plain scan.,To confirm the quality of the lesion.,Differential d
4、iagnosis of tumor and edema .,MRA:,To show the vascular lesions such as aneurysm and arterial venous malformation.,To display tumors, hemorrhage, infarction, infection and abnormality.,The characters of the lesion including size, appearance, number, position , anatomy relation ,and so on can be show
5、n by it.,5. DSA,To show the vascular lesions such as aneurysm, arterial venous malformation.,blood supply of neoplasm,6. Myelography,To show whether there are tumors and obstruction in spinal canal. It is also helpful to ensure the position and degree of obstruction.,一、 Normal manifestation,（一）、Plai
6、n film,1.Cranium,The inner and outer plate are dense and the diploe is spongy.,2.Skull suture,All of the sutures are shown as sawtooth shadow,3.Convolutional impressions,Multiple round low density in plain film.,4.The impression of the middle meningeal artery,The impresstion of the middle meningeal
7、artery is presented as streaks shadow and go out from wide to narrow,5. Impression of diploic vein,7. The Sella :,6. Impression of pacchionian granulation,8. Internal auditory meatus:,About 6mm wide ,symmetrical canal,The frontal parietal irregular hypodensity near the midline.,The diploic veins imp
8、ress appears as netlike hypodensity in the parietal region .,716mm long, 714mm wide and 820mm deep.,10.calcification of falx cerebri :,9. Calcification of pineal body :,11.Calcification of choroid plexus,12 Calcification of petro-clinoid ligament :,It is presented as nodular hyperdensity on the late
9、ral skull radiograph.,The frontal view show the normal position are presented the zonary dense image on the midline .,Calcification of choroid plexus are presented the anomalistic dense image and lateral to midline.,The dense shadow between in the anterior and posterior clinoid process.,1. White mat
10、ter: is hypodense to gray matter. CT values is 20-30Hu,2. Gray matter: is hyperdense to white matter . CT values is 30-40Hu,3. Ventricle and cistern : are hypodense. CT values is 0-10Hu,4. Skull : is hyperdense. CT values 250Hu,5. Physiological calcification:,Spot or patch dense shadow. CT values60H
11、u,二、 CT manifestation,三、 MRI manifestation,1 . Morphological manifestation,Axial, coronal,sagittal MRI can clearly show the shape of brain and spinal cord,such as white matter,grey matter,ventricle,cerebral fissure,brainstem,cerebral vessel,pituitary body,et al. The efficiency is close to gross spec
12、imen .,MRI signal intensity,Frontal lobe,Pituitary body,Central sulcus,Pituitary stalk,Optic chiasm,Genu of corpus callosum,Medulla oblongata,Clivus,Sphenoid sinus,Parietal lobe,Thalamus,Occipital lobe,Mamillary body,Quadrigeminal body,Straight simus,4th ventricle,Cerebellar tonsil,Genu of corpus ca
13、llosum,Frontal lobe,Splenium of corpus collosum,3rd ventricle,Thalamus,Head of caudate nucleus,Globus pallidus,Occipital lobe,Optic radiations,Septum pellucidum,Posterior horn of lateral ventricle,Anterior horn of lateral ventricle,Interventricular foramen,Parietooccipital sulcus,Thalamus,Head of ca
14、udate nucleus,Globus pallidus,Occipital lobe,Optic radiations,Anterior horn of lateral ventricle,Interventricular foramen,3rd ventricle,Genu of corpus callosum,Septum pellucidum,Splenium of corpus collosum,Posterior horn of lateral ventricle,Posterior limb of internal capsule,Genu of internal capsul
15、e,Anterior limb of internal capsule,Parietooccipital sulcus,Parietal lobe,Superior temporal gyrus,Middle temporal gyrus,Pons,Medulla oblongata,Cerebral peduncle,Centrum semiovale,3rd ventricle,Inferior temporal gyrus,Petrous ridge of temporal bone,Parahippocampal gyrus,Anterior horn of lateral ventr
16、icle,Lateral fissure,Suprasellar cistern,Pituitary body,Temporal lobe,Inerhemisperic fissure cistern,Corpus callosum,caudate nucleus,globus pallidus, putamen,Optic chiasm,Pituitary stalk,Cavernous sinus,DSA manifestation,Normal cerebral artery (anterior and middle cerebral artery) gradually taper off with symmetric branches and smooth margin. The arteries have invariable location and corresponding brain tissue.,Imageologic diagnosis of the common disease,（一） Brain tumors,
