1. Central nervous system
Guanghui Yu
Radiology college

2. Central nervous system
Brain
Spinal cord

3. Radiographic technique
brain
Spinal
cord
Image acquisition time
application
Plain film
invisible
elimination CT
visible
fast
Emergency
radiology
MRI
low
others
DSA
vessels
vascular diseases

4. Grey and white matter Neural tissue white matter
Fatty substance (white in color)
Axon (surrounded by myelin)
CT MR
T1WI T2WI
white matter hypodense high low
Grey matter hyperdense low high
Cell body (more H2O)
Grey matter

5. hyperdense
hypodense
Grey matter
white matter

6. hypointensity
(Grey matter)
hypointensity
hyperintensity
(white matter)
hyperintensity
T2WI
T1WI

7. Fluid attenuated inverse recovery
T1WI
FLAIR T2WI

8. The brain consists of a、the brain stem b、the cerebellum
c、the forebrain
cerebellum
midbrain
pons
medulla oblongata
Spinal cord
cerebellar tonil

13. the forebrain occipital lobe insular lobe parietal lobe frontal lobe
temporal lobe
occipital lobe
insular lobe

14. Corona radiata

16. Lentiform nucleus
Basal ganglia
Head of caudate nucleus
Genu of Corpus callosum
External capsule
Internal capsule
Thalamus
Splenium of Corpus callosum

17. A midline Post-contrast Sagittal T1 Weighted MRI4 3 5 6 2 1 7
1. Scalp fat
2. Bone
3. Inferior sagittal sinus
4. Corpus callosum
5. Internal cerebral vein
6. Vein of Galen
7. Superior sagittal sinus
8. Parietal lobe
9. Occipital lobe
10. Straight sinus
11. Vermis
12. IV ventricle
13. Cerebellar tonsil
14. Cervical cord
15. Medulla
16. Pons
17. Midbrain
18. Mass intermedia of thalamus
19. Anterior III ventricle
20. Optic chiasm
21. Pituitary gland
22. Sphenoid sinus
23. Nasopharynx
24. Frontal lobe 8 9 24 10 18 19 17 20 21 16 22 11 12 15 23 13 14
A midline Post-contrast Sagittal T1 Weighted MRI

18. 2. Cerebellar hemisphere 3. IV ventricle 4. Superior vermis 8 7 6 3 5 2 4 1
1. Cerebellar tonsil
2. Cerebellar hemisphere
3. IV ventricle
4. Superior vermis
5. Tentorium
6. Posterior temporal lobe
7. Choroid plexus within lateral ventricle
8. Posterior frontal lobe
Coronal Section of the Brain at the level of IV Ventricle
Post Contrast Coronal T1 Weighted MRI

19. Meninges dura mater the outer layer arachnoid mater the middle layer
pia mater the inner layer inseparable from the brain
The cranial dura is formly adherent to the periosteum of skull bones
The arachnoid mater is loosely adherent to the dura mater
Between the arachnoid and the pia is the subarachnoid space

20. A double layer of dura projects into the cranial cavity.
These dural folds form:
Falx cerebri
Tentorium cerebelli
Diaphragm of sella turcica

21. meninges: Falx cerebri dura Tentorium cerebelli
Subarachnoid space
Falx cerebri
dura
arachnoid
Tentorium cerebelli
pia mater
Diaphragm of sella turcica

22. cerebral falx

23. cerebral falx
Tentorium cerebelli

24. ventricular system and cerebrospinal fluid
Anterior horn of lateral ventricle
third ventricle
Lateral ventricle
Interventriculer foramen
Foramen of Monroe
Cerebral aqueduct
Fouth ventricle
posterior horn of lateral ventricle
inferior horn of lateral ventricle
inferior horn of lateral ventricle
posterior horn of lateral ventricle

25. pineal body

27. Cerebrospinal fluid circulation and cistern
Produced by the choroid plexus in all ventricles
Foramen of Monro
Cerebrospinal fluid
the lateral ventricle
the third ventricle
cerebral aqueduct
the fouth ventricle
Median and lateral aperture
of fourth ventricle
Subarachnoid space
arachnoid granulation
Superior sagittal sinus

29. cistern：
At several sites where the surface of the brain is deeply fissured, the subarachnoid space is wider than at other sites.
bilateral：
interhemispheric cistern
cistern of lateral sulcus
cisterna ambiens
cistern of pedunculus cerebellaris pontinus

30. Answers 14 13 12 Post Contrast sagittal T1 Wtd M.R.I. 11
Section at the level of Pons 17 10
Answers 16 15 9
13. Internal Carotid Artery
14. Cavernous Sinus
15. Middle Cerebellar Peduncle
16. Internal Auditory Canal
17. Temporal Lobe
8. Cerebellar Hemisphere
9. Vermis
10. IV Ventricle
11. Pons
12. Basilar Artery 8
Post Contrast Axial MR Image of the brain

31. facial nerve
acoustic nerve

32. cisterna venae magnae cerebri
unilateral：
dorsal
cisterna venae magnae cerebri
quadrigeminal cistern
ventral
cistern of chiasma
interpeduncular cistern
consecutive
suprasellar cistern

33. suprasellar cistern chiasma Cerebral peduncle hexagon
interpeduncular cistern

34. suprasellar cistern
posterior communicating artery
basilar artery
anterior cerebral artery
Vertebral
artery
middle cerebral artery
basilar artery
posterior cerebral artery
internal carotid artery

35. cranial sinuses

36. Pituitary gland neurohypophysis adenohypophysis posterior pituitary
anterior pituitary

37. Pituitary gland MR thin slice scan Coronal and sagittal scan
Height:<7millimeter
superior margin: flat or depressed
Pituitary stalk:<4millimeter

38. 9. Internal carotid artery 10. Cavernous sinus 11. Sphenoid sinus 2 3 4 5 6
1. Frontal lobe
2. Corpus callosum
3. Frontal horn
4. Caudate nucleus
5. III ventricle
6. Optic nerve
7. Pituitary stalk
8. Pituitary gland
9. Internal carotid artery
10. Cavernous sinus
11. Sphenoid sinus
12. Nasopharynx 8 7 9 11 10 12
Coronal Section of the Brain at the level of Pituitary gland
Post Contrast Coronal T1 Weighted MRI

39. Contrast enhancement ：
Normal calcification：
pineal body 、cerebral falx、choroid plexus、globus pallidus
Contrast enhancement ：
pituitary gland、pineal body、dura、
choroid plexus

40. Answers 41 40 Post Contrast sagittal T1 Wtd M.R.I.
Section at the level of Corpus Callosum 39
Answers
39. Splenium of corpus callosum
40. Choroid plexus within the
body of lateral ventricle
41. Genu of corpus callosum
Fig. 1.7 Post Contrast Axial MR Image of the brain

41. 2. Cerebellar hemisphere 3. IV ventricle 4. Superior vermis 8 7 6 3 5 2 4 1
1. Cerebellar tonsil
2. Cerebellar hemisphere
3. IV ventricle
4. Superior vermis
5. Tentorium
6. Posterior temporal lobe
7. Choroid plexus within lateral ventricle
8. Posterior frontal lobe
Fig Coronal Section of the Brain at the level of IV Ventricle
Post Contrast Coronal T1 Weighted MRI

42. Abnormal changes of CT scan
　a、hyperdense：calcification、hemorrhage、tumor　
b、 hypodense ：edema、 tumor 、cystis、liquefactive necrosis、lipoma、 fluid　
c、 isodense ：chronic hamorrhage、 tumor
d、heterogeneous density ：

43. calcification
value >100Hu
exceed

48. b. hypointensity：edema、fluid、tumor、fibrosis and calcification
Abnormal change of MRI
A、T1WI：
　a. hyperintensity：fat or lipoid、melanin、constrast medium
　b. hypointensity：edema、fluid、tumor、fibrosis and calcification
B、T2WI：
　a. hyperintensity ： edema、fluid、tumor 、
　b. hypointensity ： fibrosis and calcification 、 melanin
C、mass effect

50. mass

51. mass

52. evolution of hematoma and intensity of MRI
T1WI　　　　 　T2WI
ferrohemoglobin 　　iso-　　　　　　 iso-
ferrohemoglobin 　　iso-　　　　　　hypo-
methemoglobin
akaryocyte　　 hyper-　　　　　hypo-
membranolysis　 hyper- 　　　　 hyper-
hemosiderin 　　 hypo- 　　　　 hypo- 　

53. Acute
A week later

54. methemoglobin

55. hemosiderin

56. 1、obstructive hydrocephalus
Hydrocephalus (increased volume of cerebrospinal fluid)
1、obstructive hydrocephalus
2、communicating hydrocephalus
3、exterior hydrocephalus

57. Cerebral aqueduct
communicating hydrocephalus

58. obstructive hydrocephalus

59. exterior hydrocephalus

60. exterior hydrocephalus

61. white matter and grey matter
edema
type
location
cause
water
vasogenic edema
white matter
Tumor
inflammation
trauma
hydrated water
cytotoxic edema
white matter and grey matter
acute infarction
few

62. vasogenic edema

63. cytotoxic edema

64. Thank you