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Analysis of CT images of the head
Last reviewed: 23.04.2024
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Each doctor determines the sequence of examination of the images. "The only correct" tactic does not exist. The radiologist is free to choose between several standard methods. But a clear sequence of image analysis has the advantage that small details are not left out. This is especially true for beginning doctors.
Inspection of the sections begins with an estimate of the size of the ventricles and SAP, so as to immediately eliminate the volume formation that threatens the patient's life. It should be noted that with age, the width of SAP increases. Then it is necessary to carefully evaluate the boundary between the gray and white matter of the brain. The veiling of the border is a sign of cerebral edema. If pathological changes are suspected, you should carefully inspect adjacent sections to avoid incorrect conclusions due to the possible effect of a private volume.
[Recommendations for the analysis of a computer tomogram of the head
Age (the width of the SAP / brain atrophy depends on this)
Anamnesis:
- risk factors
- (trauma -> possible intracranial hematoma)
- (arterial hypertension, diabetes, smoking -> stenosis of the arteries, stroke)
Signs of volumetric neoplasm:
- the configuration of the IV-th ventricle (located behind the bridge)
- the configuration of the third ventricle (located between the visual cusps, narrow / creviceous)
- symmetry of the lateral ventricles (concave outer contour of anterior horns and central part)
- displacement of the middle structures (a sign of volumetric education)
- safety of the basal cistern (cistern quadruple in the form of a "smile on the face" / figures Batman)
- cortex <-> clear separation of white matter from gray (blurred border - a sign of edema)
- matched width of EPS
Focal educations:
- when contrasting are not intensifying: differential diagnosis of physiological calcifications (vascular plexus, pineal gland / partial volume) with dense sites of hemorrhage (differential diagnosis of hemorrhage types)
- with contrasting intensifying: a sign of violation of BBB (due to tumor, metastases, inflammatory changes)
Pathological changes in bones:
- in the bone window, a control examination of the arch and the base of the skull is performed to exclude the centers of osteolysis / contact destruction due to tumor infiltration
- in patients with trauma, fractures are excluded (especially the bases and the front of the skull - differential diagnosis with interosseous sutures)