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(1)

Brain Anatomy on CT & MRI

Rebecca L. Frame, BS, CMD

Rebecca L. Frame, BS, CMD

(2)

1. Brain Facts

2. MRI Imaging Techniques

3. How the Various Imaging Helps Us in Treatment

Objectives

3. How the Various Imaging Helps Us in Treatment

Planning

4. Locate and Identify Pertinent Cerebral Anatomy

on CT and MRI Images

(3)

MD Anderson Facts & Figures

MD Anderson Main Campus

Main Center

Ambulatory Clinic Building

Proton Therapy Center

4 Regional Cancer Centers

Greater Houston Ar

ea

Albuquerque New Mexico

Istanbul, Turkey

MD Anderson Banner Cancer Center, AZ

(4)

MD Anderson Facts & Figures

Physicians

63

Dosimetrists

48

Radiation Therapists

99

Average Patient Treatment per Day

679

(5)

Brain Exercise #1

Q. Who is Samuel Clemens?

A. More familiarly known as Mark Twain,

was born in Florida, Missouri and grew up in nearby Hannibal. Beginning his career as a printer’s apprentice for the Missouri

Courier in Hannibal, he eventually wrote Courier in Hannibal, he eventually wrote

for the Keokuk, Iowa Saturday Post. Soon thereafter, however, he abandoned his

literary career and spent 18 months as a riverboat pilot on the Mississippi River. After the Civil War, he returned to writing for newspapers and magazines, before writing his novels based on life on the Mississippi River, such as Tom Sawyer and The Adventures of Huckleberry Finn.

(6)

The Brain

The human brain has various parts that are

used to control various functions of

our body

Brain of an average adult

Brain of an average adult

about 1000 billion neurons

weighs about 1300 grams

Protected in the brain box, cranium or skull

Covered by three membranes called

(7)

Space between membranes is filled by

cerebrospinal fluid

Serves as a shock absorbing medium

Protects the brain against mechanical shocks

T

he Brain

Protects the brain against mechanical shocks

Maintains constant pressure in and around

the brain

Helps in the exchange of nutrients and waste

products between the nerve tissue and the

(8)

Parts of Brain and Their Control

Forebrain:

Cerebrum

The most specialized

largest part of brain

largest part of brain

Highly folded to increase

surface area

Made up of two

hemispheres called

cerebral hemisphere

(9)

Parts of Brain and Their Control

Occipital Lobe: Region for sight

Temporal Lobe: Region for

hearing

Frontal Lobe: Region for

speech, facial muscular activities

and mental activities

Different areas of

cerebrum control

different body parts and

functions

ohsu.edu

and mental activities

Parietal Lobe: Region for taste,

smell, touch, temperature and

consciousness

•There are some areas in each

lobe which control thinking and

memory

•Store information &

experience

•Cerebrum controls all voluntary

activities.

(10)

Parts of Brain and Their Control

Mid - Brain:

Controls reflex

movements of the

head, neck and trunk

in response to visual

in response to visual

and auditory stimuli

Connects the hind

brain with forebrain

and conveys impulses

(11)

Parts of Brain and Their Control

Hind Brain:

Posterior,

Small part of the

brain

brain

Differentiated into

three parts:

pons,

cerebellum

(12)

Parts of Brain and Their Control

Pons:

Thick, white,

rounded ridge

dorsally covered by

dorsally covered by

the cerebellum.

Carries impulses

from medulla

oblongata to fore

brain and from one

lobe of cerebellum

to other lobe.

(13)

Parts of Brain and Their Control

Cerebellum:

Largest part of hind brain,

present below the

cerebrum and above the

medulla oblongata behind

medulla oblongata behind

the pons.

Consists of two large

lateral lobes called

cerebral hemisphere.

It has to maintain body balance and posture.

It controls and coordinates muscular activity.

(14)

Parts of Brain and Their Control

Medulla Oblongata:

Continuation of upper

part of spinal cord and

forms the lower part of

brain stem

brain stem

Relays motor and

sensory impulses

between other parts of

brain and spinal cord

1. Anterior median fissure

2. Olive

3. Pyramids 4. Cerebellum

(15)

Parts of Brain and Their Control

Controls involuntary

activities as follows:

Regulates heart

beat, breathing and

blood vessel

blood vessel

diameter

Coordinates reflexes

such as swallowing,

vomiting, coughing,

sneezing and

hiccuping

phoenixrising.me

(16)

Brain Exercise #2

Q. What is the capitol of Missouri?

A. The present Missouri Capitol in Jefferson City was completed in 1917 and was the sixth in Missouri history. The first seat of state government was housed in the

Mansion House in St. Louis, the second Mansion House in St. Louis, the second was in the Missouri Hotel in St. Louis, St. Charles was designated as temporary

capital of the state in 1821 and remained the seat of government until 1826 when Jefferson City became the permanent capital city. The current building was the third in Jefferson City as the first burned in 1837, the second burned in 1911.

(17)

MRI Imaging Techniques

Magnetic Resonance

Imaging

Provides good contrast

between the different

soft tissues of the body,

soft tissues of the body,

which make it

especially useful in

imaging the brain,

muscles, the heart, and

cancers. Unlike CT

scans or traditional

X-rays, MRI uses no

(18)
(19)

MRI Imaging Techniques

T

1

-weighted MRI

Standard basic scan, in

particular differentiating fat

from water - with water

darker and fat brighter

darker and fat brighter

A contrast agent is also

commonly use, with scans

before and after contrast is

given

In the brain T

1

-weighted

scans provide good gray

matter/white matter contrast

(20)

MRI Imaging Techniques

ispub.com

A. T1-weighted MRI

B. T2-weighted MRI

T

2

-weighted MRI

A standard basic scan.

Like the T

1

-weighted scan, fat is differentiated from water.

Fat shows darker, and water lighter.

A contrast agent is also commonly used

(21)

MRI Imaging Techniques

FLAIR

Fl

uid

a

ttenuation

i

nversion

r

ecovery

Suppress the signals generated by fluids in

the body

the body

Unwanted signals from cerebrospinal fluid in

the brain, and darken the portions of the

images containing this fluid

(22)
(23)

Various Imaging Helps Us in

Treatment Planning

(24)
(25)

Brain Exercise #3

Q. What does the Jefferson National Expansion Memorial consist of?

A. Jefferson National Expansion Memorial consists of the Gateway Arch, the

Museum of Westward Expansion, and St. Louis Old Courthouse. During a

Louis Old Courthouse. During a nationwide competition in 1947-48,

architect Eero Saarinen's inspired design for a 630-foot stainless steel arch was

chosen as a perfect monument to the spirit of the western pioneers.

Construction of the Arch began in 1963 and was completed on October 28, 1965.

(26)

Pertinent Cerebral Anatomy on CT

and MRI Images

(27)

Pertinent Cerebral Anatomy on CT

and MRI Images

(28)

Pertinent Cerebral Anatomy on CT

and MRI Images

(29)

1

2

3

(30)

7

8

9

(31)

Regions of the Brain

Clivus/ Pituitary Area Clivus/ Pituitary Area Midbrain Frontal Parietal & Occipital Temporal Temporal Cerebellum Clivus/ Pituitary Area Clivus/ Pituitary Area Parietal & Occipital BS BS

Frontal, Parietal/Occipital, Temporal, Midbrain, Brainstem,

Cerebellum, & Clival/Pituitary Regions

(32)

Functional MRI

Functional MRI is a

very powerful

method to map

brain functions

Determine precisely

which part of the

brain is handling

critical functions

such as thought,

speech, movement

and sensation

(33)

Functional MRI

The Patient is asked to perform a

particular task during the imaging

process.

This causes increased metabolic

This causes increased metabolic

activity in the area of the brain

responsible for the task.

This activity, which includes expanding

blood vessels, chemical changes and

the delivery of extra oxygen, can then

be recorded on MRI images.

(34)

Functional MRI

In treatment planning

it is useful to map

these functions,

particularly speech, in

order to minimize

order to minimize

radiation induced

damage

Pediatric patients

(35)
(36)

Brain Exercise #4

Q. What is the largest beer producing plan in the US?

A. Anheuser-Busch brewery in St Louis, Missouri is the largest beer producing plant in the nation.

You can take a free tour of the Anheuser-Busch You can take a free tour of the Anheuser-Busch Brewery (www.budweisertours.com), which includes stops at the Brew House,

Budweiser Clydesdales' stables, the lager cellar, packaging plant, and the A-B gift shop. At the end of the tour, guests ages 21 and over can sample a variety of

Anheuser-Busch brands, and those under 21 years of age can enjoy complimentary soft drinks and snacks.

(37)

References

Matt Palmer, MBA, CMD

Anita Mahajan, MD

Technical Basis of Radiation Therapy by

Seymour H. Lewis, p 64

Seymour H. Lewis, p 64

Basic Atlas of Sectional Anatomy, 3

rd

Edition,

Bo, Walter J./ Wolfman, Neil T./ Krueger,

Wayne A./ Carr, J. Jeffrey/ Bowden, Robert I./

Meschan, Isadore

How The Body Works, General Editor Dr.

Peter Abrahams

(38)

References

Wikepedia

IMAIOS

eHow

Mayoclinic.org

Brainethics.org

Cedar-sinai.edu

Howaboutbeer.com

LegendsofAmerica

References

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