1. Brain (CT, MRI & Angiography)
時間：
授課教師:薛俊仁 醫師
三軍總醫院 放射診斷部

2. 1.Frontal bone
2.Parietal bone
3.Dura mater
4.Arachnoid mater
5.Pia mater
6.Superior sagittal sinus
7.Superior cerebral vein
8.Arachnoid granulation

3. Central sulcus 1.Frontal bone 2.Parietal bone 3.Sagittal suture
4.Dura mater
5.Arachnoid mater
6.Superior sagittal sinus
7.Falx cerebri
8.Subarachnoid space
9.Pia mater
Central sulcus

4. 1.Frontal bone
2.Parietal bone
3.Skin and dense
subcutaneous tissue
4.Epicranial aponeurosis
(galea aponeurotica)
5.Pericranium
6.Branches of superficial
temporal artery
7.Sagittal suture
8.Dura mater
9.Arachnoid mater
10.Superior sagittal sinus
11.Falx cerebri
12.Grey matter
13.White matter

5. 1.Frontal bone
2.Parietal bone
3.Skin and dense
subcutaneous tissue
4.Epicranial aponeurosis
(galea aponeurotica)
5.Temporalis
6.Pericranium
7.Branches of superficial
temporal artery
8.Sagittal suture
9.Dura mater
10.Arachnoid mater
11.Superior sagittal sinus
12.Falx cerebri
13.Cingulate gyrus
14.Parieto-occipital sulcus
15.Corona radiata
16.Anterior cerebral artery
(branches)
17.Postcentral gyrus
18.Central sulcus

6. 1.Frontal bone
2.Parietal bone
3.Skin and dense
subcutaneous tissue
4.Epicranial aponeurosis
(galea aponeurotica)
5.Temporalis
6.Pericranium
7.Branches of superficial
temporal artery
8.Diploic vein
9.Dura mater
10.Arachnoid mater
11.Sagittal suture
12.Superior sagittal sinus
13.Lunate sulcus
14.Falx cerebri
15.Cingulate gyrus
16.Postcentral sulcus
17.Central sulcus
18.Roof of body of lateral
ventricle
19.Corona radiata
20.Corpus callosum
21.Longitudinal fasciculus
(cortico cortical fibres)
22.Anterior cerebral artery
(branches)
23.Forceps minor
24.Cingulate sulcus
25.Inferior sagittal sinus

7. 1.Frontal bone
2.Parietal bone
3.Sutural bone
4.Skin and dense
subcutaneous tissue
5.Epicranial aponeurosis
(galea aponeurotica)
6.Temporalis
7.Pericranium
8.Branches of superficial
temporal artery
9.Occipital vein
10.Superior sagittal sinus
11.Falx cerebri
12.Straight sinus
13.Parieto-occipital sulcus
14.Optic radiation
15.Chorlid plexus
16.Posterior horn lateral ventricle
17.Splenium of corpus callosum
18.Lateral sulcus (Sylvian fissure)
19.Third ventricle
20.Middle cerebral artery (branches)
21.Postcentral sulcus
22.Central sulcus
23.Arachnoid mater
24.Dura matter
25.Thalamostriate vein
26.Body of lateral ventricle
27.Body of caudate nucleus
28.Frontal horn of lateral ventricle
29.Septum pellucidum
30.Insula
31.Claustrum
32.Putamen
33.Internal capsule
34.Circular sulcus
35.Genu of corpus callosum
36.Anterior cerebral artery (branches)
37.Forceps minor
38.Cingulate sulcus
39.Supra-orbital artery

8. 1.Supra orbital artery
2.Frontal belly of occipitofrontalis
3.Frontal sinus
4.Frontal bone
5.Parietal bone
6.Middle meningeal artery and vein
7.Branch of temporal artery
8.Sliver of squamous part of
temporal bone
9.Skin and dense
subcutaneous tissue
10.Epicranial aponeurosis
(galea aponeurotica)
11.Temporalis
12.Pericranium
13.Dura matter
14.Arachnoid mater
15.Occipital artery
16.Squamous part of occipital bone
17.Superior sagittal sinus
18.Occipital lobe
19.Falx cerebri
20.Calcarine sulcus
21.Straight sinus
22.Great cerebral vein
23.Fornix
24.Internal cerebral vein (branches)
25.Pulvinar of thalamus
26.Optic radiation
27.Medial nucleus of thalamus
28.Third ventricle
29.Ventroposterior thalamic nucleus
30.Circular sulcus
31.Globus pallidus-internal segment
32.Globus pallidus-enternal segment
33.Choroid piexus in interventricular
foramen (Monro)
34.Claustrum
36.Insula
36.Putamen
37.Middle cerebral artery (branches)
38.Anterior limb of internal capsule
39.Caudate nucleus-head
40.Corpus callosum
41.Anterior cerebral artery
42.Frontal horn of lateral ventricle
43.Frontal lobe

15. Frontal lobe: precentral gyrus
Central sulcus:
Parietal lobe: post central gyrus F P

17. Brain Cerebrum (frontal, parietal, temporal, occipital lobe)
Cerebellum (hemispheres, vermis)
Midbrain
Pons
Medulla oblongata
Cervical cord

19. Midbrain (9)
Pons (6)
Medulla oblongata (5)
Cervical cord (4)

20. Central sulcus
Cingulate sulcus
Parieto-occipital sulcus
Cerebellum tentorium

21. Cranial nerves
CN2
CN3
CN5
CN7&8
CN12

22. ACA
MCA
PCA

23. CT

25. CT angiography Common carotid artery Internal carotid artery
Vertebral artery
Basilar artery
Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery

26. Intracranial Hemorrhage
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Parenchymal hematoma
Intraventricular hemorrhage 26

27. Intraventricular hemorrhage
F21, Sudden onset intractable headache nausea & vomiting – an AVM supplied by right MCA 27

29. Brain tumor: meningioma

30. F54 sudden onset right limb weakness

31. TAE
MMA

32. Navigator MR , 7 days after TAE

33. Follow up
4 month later
One and half years later

34. Ischemic infarction Hyperdense MCA sign
F68 right upper and lower limb weakness – left MCA territory infarct
Follow up 2 days later 34

35. Acute left MCA infarct
ACA
MCA

36. For comparison
Posterior circulation
Acute infarct involving posterior circulation

37. MRI-磁振造影基礎序列(sequence): 提供不同軟組織對比
T1-weighted image T2-weighted image FLAIR DWI
T1 權重影像 T2權重影象 液體衰減影象 水分子擴散影象 37

38. ICA AP view Lateral view38

39. Posterior circulation:
-Vertebral artery (VA); 1,2
-Basilar artery (BA); 5
-Posterior inferior cerebellar artery (PICA); 4
-Anterior inferior cerebellar artery (AICA); 6
-Superior cerebellar artery (SCA); 8
-Posterior cerebral artery (PCA); 9
-Posterior communicating artery (Pcom A); 10

40. External carotid artery

41. Pial arteriovenous fistula with ICH

42. Digital-Subtraction cerebral Angiography (DSA)
Invasive study; CTA普遍運用後，角色轉為TAE procedure 的一部分或CTA所給資訊不足時的輔助工具。
Bi-planes angiographic machine 亦可提供 3D 立體影像，並作為Pre-procedure planning。

43. CTA vs 3D DSA vs MRA

44. Corpus callosum
Midbrain
Pons
Medulla
Pituitary gland
Cervical cord

48. Thanks for your attention