Neuroradiology And Ultrasound


Intraoperative ultrasound (IOUS) may be used as a guide in both brain and spinal surgery. In the spine, ultrasound may be used to guide the approach to a tumor, reducing the extent of the laminectomy and dural opening. With intramedullary tumors, the extent of the posterior myelotomy can be defined, together with the presence of syringomyelic cavities and deep tumor extension [25]. In some cases there may be pointers to a histological diagnosis and, where indicated, ultrasonic-guided aspiration and biopsy can be performed. Similarly, IOUS is well able to localize and define the margins of both superficial and deep intracranial tumors, and can subsequently accurately determine the extent of resection.

Finally, IOUS may be of use in the evaluation of both the brain and spinal cord in trauma patients. Localization of hematomas, bone fragments and foreign bodies is possible and ultrasound may subsequently provide dynamic guidance to facilitate their removal.


The future of neuroradiology will see further development of MRI so that it becomes the central, and often only, diagnostic tool needed. MRA and CTA will replace diagnostic angiography. Functional and physiological data will be routinely available although newer techniques, such as magnetoencephalography, may have a limited role in complementing MRI. CT scanning will remain important and even myelogra-phy will have a limited role. The neuro-radiologist will remain central, being the interface between the application and interpretation of these sophisticated technologies and the clinical problems of the patient.


□ What are the features of a subdural empyema on a CT scan?

□ What are the MRI appearances of an acute parenchymal hematoma?

□ What are the common hemorrhagic tumors of the brain and what are their characteristic features on MRI?

□ What are the complications of cerebral angiography?

□ A patient presenting with subarachnoid hemorrhage is found to have multiple aneurysms. How do you decide which has bled?


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