Neuroradiology is a subspecialized field of radiology uses imaging techniques to diagnose and treat disorders associated with the brain, spine, head, neck, and blood vessels. The disorder conditions such as stroke, tumours, trauma, infections, and degenerative diseases can be evaluated by CT, MRI, angiography, and ultrasound.
Neuroradiology Reporting is the process used to analyze & interpret the medical images of the brain, spine, spinal cord, head, and neck to create a diagnostic report to help doctors diagnose and treat neurological conditions. It works by sending the scans to expert neuroradiologists to analyze the images. He makes an accurate diagnostic report to guide urgent or routine treatment. These reports are prepared by expert neuroradiologists using advanced imaging like CT, MRI, CTA, MRA, and DSA.
Neuroradiologists are responsible for the accurate interpretation of complex neuroimaging. Their primary duty involves analyzing imaging data to identify both subtle and overt neuropathologies. Every anatomical layer, vascular pattern, and signal variation is evaluated with precision. Interpretative responsibility includes detection of tumors, vascular lesions, hemorrhages, infarcts, infections, degenerative diseases, and trauma-related changes. Their responsibilities may also include:
Given below are some of the imaging modalities used to assess the neurological anatomy and physiology.
MRI is an advanced, non-invasive technique to obtain high quality 3D images of organs, bones, and soft tissues. This imaging strategy yields high resolution images of tumors, injuries and blood clots. The principle consists of the systematic alignment ad disruption of water molecules under a strong magnetic field in the presence of radio frequency pulses. This alignment and disruption cause emission of energy which aids in capturing the high-resolution images of the area of interest
CT is another technique used in neuroradiology which can generate sharp 3D images. Using this method, the patient is exposed to X-rays through different angles. The X rays passing through the body are then captured through the detectors. Next, using tomographic reconstruction, the 2D images are then aligned to obtain the complex 3D images.
As understood by its name, this technique utilizes ionizing radiation to create 2D images. These radiations pass through the body and captured by the detectors, creating a shadow like image of the internal structure. Using X-ray imaging, neuroradiologists can accurately observe the bone structure and any abnormalities in them, in a clear 2D format. This is a quick, inexpensive method, but has limitations regarding poor soft tissue appearance, radiation exposure risks and overlapping of artefacts.
This method incorporates an additional step to the existing CT working. A high-contrast dye is introduced in the blood stream, which aids in the visualization of fine arteries and blood vessels. These contrasts are then captured and processed following the same techniques used in computed tomography.
DTI is useful in imaging of anisotropic water diffusion in the white matter. It is a specialized form of MRI, which is effective in to observe nerve pathways. Using this method, the practitioner can generate an anisotropy map or color-coded tactography. This high precision method can easily detect damage due to trauma, stroke, or demyelination via reduced FA values. A major limitation of DTI is its high sensitivity is edema, which can lead to false positives, and crossover of nerve fibers.
Neuroradiology is widely used to identify various conditions involving the brain, spinal cord, neck and heart, as listed below:
Neuroradiology is broadly classified into three main branches, as explained below:
As suggested by the name, this category of neuroradiology is used for the imaging and interpretation of certain conditions. It employes techniques like MRI, CT, and angiography to diagnosis disease conditions f the brain, neck and spinal cord.
These methods consist of minimally invasive procedures guided by imaging techniques. These procedures are useful for performing anatomical level interventions with high precision. Common procedures used under interventional neurology include embolization, stent placement, and aneurysm coiling.
Both diagnostic and interventional neuroradiology categories can be further subdivided into special categories. These categories include pediatric neuroradiology, head and neck imaging, neurovascular imaging, brain tumor imaging, spine imaging, etc.
Diagnostic neuroradiology uses imaging techniques to examine the internal structure of brain, spine, or neck. Interventional neuroradiology makes use of this structural information to perform minimally invasive procedures.
A neuroradiological examination is typically carried out for acute stroke evaluation, intracranial hemorrhage, brain tumors, infection/inflammation, spinal pathology, demyelinating disease, traumatic injuries, and vascular abnormalities.
There are certain pre-procedure steps required before a neuroradiological examination. Patients must follow the instructions given by the neuroradiologist strictly, inform about allergies, kidney function, pregnancy status, and implanted devices.
A neuroradiological examination offer insights into the structural and anatomical features of certain organs. To accurately form conclusions based on these results, neurologists combine clinical history, existing symptoms, and the imaging results to form a concrete diagnosis.
A neuroradiological examination is generally recommended by a healthcare practitioner first, based on the clinical history. Patients may find facilities for an examination in hospital radiology departments, medical academic centers, or specialized clinics.
All neuroradiologists are required to undergo a specialized training and certification to perform neuroradiology procedures. Additionally, there are standardized guidelines for pre, post and throughout the operation. Neuroradiologists must follow these guidelines strictly.
Some of the common neuroradiological procedures include Lumbar puncture, cyst or tissue biopsies, spinal injections, cisternograms, and targeted vascular interventions.
Some of the typical signs neuroradiologists look for consist of acute infarcts (DWI hyperintensity), hemorrhages (CT hyperdensity or GRE blooming), enhancing tumors, ovoid T2/FLAIR MS plaques (Dawson's fingers), saccular aneurysms on MRA, and ring-enhancing abscesses with restricted diffusion. These signs are positive indicators of stroke, trauma, neoplasms, demyelination, vascular anomalies, and infections.
