Cns Brain

Front 1

Non-BBB penetrating RP's
used for brain imaging

Back 1

Tc99mNa04,
Tc-DTPA,
Tc-Glucoheptonate,
Tl-201,
Ga-67,
Tc99m-phosphonates(MDP, HDP)

Front 2

BBB penetrating brain RP's

Back 2

123I-IMP & HIPDM (not in US)
Tc-HMPAO (exametazine)
Tc-ECD (bicisate)
Xe-133

Front 3

dose Tc99mNa04

Back 3

15-25mCi (use K to stop acc. in Choroid plexus)

Front 4

dose Tc-DTPA

Back 4

15-20mCi

Front 5

dose Tc-GH

Back 5

10-20mCi

Front 6

of DTPA, GH, and Tc which is fastest, medium, slowest

Back 6

DTPA fastest, GH next, then Tc is slowest

Front 7

imaging wait time Tc

Back 7

0hr -4hr

Front 8

imaging wait time Tc-DTPA

Back 8

0-60min

Front 9

imaging wait time Tc-GH

Back 9

0-4hr

Front 10

imaging wait time Tl-201

Back 10

0-60min

Front 11

imaging wait time Ga-67

Back 11

24-72hr

Front 12

imaging wait time Tc-phosphonates

Back 12

0-4hr

Front 13

Dose Tl-201

Back 13

2-3mCi

Front 14

Dose Ga-67

Back 14

3-6mCi

Front 15

Dose Tc- phosphates

Back 15

15-20 mCi

Front 16

Dose 123I-IMP

Back 16

3-5mCi

Front 17

Imaging time 123I-IMP

Back 17

immediate-redistributed after 1 hr.

Front 18

Dose Tc-HMPAO

Back 18

20mCI

Front 19

Imaging time Tc-HMPAO

Back 19

0-4hr ( must inj. w/in 30 min of prep-unstable in vitro)

Front 20

Indications planar brain scan

Back 20

Brain death
Strokes
Mets brain tumors
Infection/inflammation

Front 21

Pt prep for planar brain scan

Back 21

start IV 20 min before inj.
pt. supine
dark, quiet room

Front 22

If inject with eyes open where will you see increased uptake? Why?

Back 22

Occipital region- visual cortex

Front 23

2 phases of planar brain scan

Back 23

dynamic
delays

Front 24

Flow planar brain scan prodecure

Back 24

Pt supine
Camera for ANT image
Bolus 15-20mCi Tc
2-3s. x 60s.

Front 25

What is the name of the method to give RP bolus?

Back 25

Oldendorf
Use inflated BP cuff, inject then release cuff

Front 26

Delay planar procedure

Back 26

Supine
static @ 20-60min p inj. or 3-4hr for Tc

Front 27

How many counts needed for delay planar brain? Which images required?

Back 27

500K count
ANT/POST & R/L lat

Front 28

Most common indication for planar brain scan?

Back 28

brain death

Front 29

How does brain death appear?

Back 29

outline of skull only seen

Front 30

How does a tumor appear?

Back 30

single focus of activity in delays

Front 31

How does mets appear in planar brain scan?

Back 31

many focal hot spots

Front 32

How do strokes appear on planar brain?

Back 32

Flow- Asymmetric
Delays- wedge shaped

Front 33

What is a doughnut sign an indication of in a planar brain scan?

Back 33

Inflammation/infection

Front 34

What is the main thing see with SPECT brain imaging?

Back 34

regional cerebral blood flow (rCBF)

Front 35

BBB penetrating RP's

Back 35

123I-amines
99Tc-HMPAO
99Tc-ECD
133-Xe

Front 36

Dose Tc99m-ECD

Back 36

20mCi

Front 37

Dose 133Xe

Back 37

1-10mCi

Front 38

Name 3 slices seen in SPECT brain imaging

Back 38

Sagittal-R to L
Transverse- top to bottom
Coronal- front to back

Front 39

Indications for brain SPECT

Back 39

CV disease
Dementia
Trauma
Locate seizure foci

Front 40

SPECT brain procedure

Back 40

Inj 20mCI TC IV
Flow opt.
Images @20min p inj.
Data reconstructed 3 planes

Front 41

Normal brain SPECT results

Back 41

RP localization proportional to blood flow, increased flow to gray matter, decrease in white matter

Front 42

Death SPECT results

Back 42

same as planar with better sensitivity

Front 43

Tumor SPECT results

Back 43

shows as local defect

Front 44

CV disease SPECT results

Back 44

reduced or no flow to area

Front 45

TIA SPECT results

Back 45

time dependant-
temporary perfusion reduction

Front 46

Epilepsy SPECT results

Back 46

Ictal-increased perfusion
Interictal- decreased perfusion
PET is best choice for this

Front 47

Dementia SPECT results
not including alzheimers

Back 47

decreased perfusion/metabolism scattered throughout the brain,
multiple or single,
bilat or unilat

Front 48

Alheimers SPECT results

Back 48

80% decreased perfusion to bilateral occipital, temporal, and parietal lobes

Front 49

What is the spinal imaging RP
(CSF, Cisternograms)

Back 49

111In-DTPA

Front 50

Dose 111In-DTPA

Back 50

0.5-1mCi

Front 51

How is 111In-DTPA injected and by whom?

Back 51

Intrathecal by radiologist

Front 52

Pt post prep CSF?

Back 52

Lie horizontal 2 hrs to prevent headaches

Front 53

How many counts and what images for cisternogram?

Back 53

100-200k Count
Initial POST images then:
ANT: 2,6,24, 48 & 72hr

Front 54

Cisternogram at 48hrs should appear as a?

Back 54

Cap, the Rp fills the sinuses

Front 55

CSF indications?

Back 55

Normal pressure hydrocephalus (NPH)
CSF leaks
Shunt patency

Front 56

NPH results

Back 56

CSF still in ventricles after 4-6hrs

Front 57

CSF leak test uses what?

Back 57

Pledgets in nose and ears which are later counted

Front 58

Shunt patency dose of Tc99m-DTPA or 111In-DTPA

Back 58

1-3mCi or 500uCi

Front 59

4 parts of the brain

Back 59

cerebrum
cerebellum
diencephalon
brain stem

Front 60

Where does Tc99m accumulate in the the planar brain imaging?

Back 60

Choroid plexus

Front 61

How do you prevent accumulation of Tc in the Choroid Plexus?

Back 61

Administer perchlorate 30-60 min before injection

Front 62

Normal SPECT accumulation

Back 62

--Bilaterally symmetrical
--Increase activity in convexities, basal ganglia and thalmus (gray matter)
--Decreased activity in the ventricles (white matter)

Front 63

CSF flow in spinal column at 2-4hr

Back 63

basal cistern

Front 64

CSF flow in spinal column at 6-24h

Back 64

sylvian & interhemispheric fissures

Front 65

CSF flow in spinal column at 24h

Back 65

complete ascent-none in cistern

Front 66

CSF flow in spinal column at 48h

Back 66

Rp makes a cap complete filling of sinuses

Front 67

Sensory function controlled by the occipital lobe

Back 67

Vision

Front 68

Sensory function controlled by the temporal lobe

Back 68

hearing, memory

Front 69

Sensory function controlled by the parietal lobe

Back 69

sensory

Front 70

Sensory function controlled by the frontal lobe

Back 70

higher mental planning, personality

Front 71

Fundamental units of the nervous system

Back 71

Neurons

Front 72

Name 3 neurotransmitters

Back 72

amines, amino acids, peptides

Front 73

norepinephrine, dopamine, & seratonin are examples of

Back 73

amines

Front 74

GABA, glutamic acid, aspartic acid, and glycine are examples of what?

Back 74

Amino acids

Front 75

Endogenous enkephalins are examples of what?

Back 75

Peptides

Front 76

The CNS is composed of what 2 things?

Back 76

Brain
Spinal cord

Front 77

Right and left hemispheres separated by the what?

Back 77

Corpus collosum

Front 78

What part of the brain is responsible for sensations of pain and temperature?

Back 78

Thalmus

Front 79

Hypothalmus responsible for what functions?

Back 79

Autonomic- body heat, water balance, pituitary fxn, hunger emotion

Front 80

What part of the brain are the hypothalmus and thalmus found in?

Back 80

Diencephalon

Front 81

What 3 things does the brain stem consist of?

Back 81

medulla, pons, midbrain

Front 82

Largest posterior cistern is the ?

Back 82

Cisterna magna

Front 83

Intrathecal injections should be done between which vertebrae

Back 83

L2-L3

Front 84

What is the main source of energy for the brain?

Back 84

Glucose

Front 85

Brain consumes what % of oxygen?

Back 85

20%

Front 86

Can planar RP's cross an intact BBB?

Back 86

No

Front 87

Afferent means?
Efferent means?

Back 87

Afferent to brain
efferent leaves brain

Front 88

3 parts of a neuron

Back 88

axon, dendrite, body

Front 89

Most common pathology of the brain?

Back 89

Epilepsy