At Rocky Mountain Neurosurgery, we utilize various imaging techniques to assist us with patient diagnosis and treatment planning. Some of the most often utilized options in Neurosurgery include MRI imaging with and without contrast dye, CT scanning, plain film x-rays and bone scanning. While the advances in imaging are extremely helpful and undergoing constant refinement, they should never take to place of a carefully performed history and physical examination. Imaging, when used correctly, serves as a great tool for the clinician and the patient to utilize when formulating a diagnosis and treatment plan.
Plain film X-rays give a clinician a nice overview of the anatomy in question and can help identify skeletal and some soft tissue disorders. When utilized to image the spine, plain films provide critical information about its the alignment and stability. X-rays are obtained periodically in the post-operative period to assess healing and hardware intergity. This type of imaging gives off radiation.
MRI scanning is often performed when more detail is desired regarding soft tissues, neural and vascular structures. It does not give off radiation but rather obtains images through the use of a magnet. Because of this, certain implanted metals within the body will react to the scan eliminating this imaging technique as an option for some patients. MRI imaging is often used with contrast dye material to help highlight abnormal vessels, inflammation, infection or tumors. A specific MRI with contrast dye is utilized to look at the vessels within the brain and neck is known as MRI Angiography.
CT scanning is utilized when bone clarity is desired or when a MRI scan cannot be performed. This is a great imaging option when looking for fractures that are suspeted but not readily apparent on plain film x-rays. CT scans are also ultilized to look for blood accumulation within the body, assess the status of a healing bone in the case of a fracture or surgical intervention or identify neural compression. For this latter application, contrast dye is used in conjunction with CT scan and is known as a CT Myelogram. In the brain, contrast is used to look closely for vessel abnomalities and this type of scan is known as a CT Angiogram. CT scanning does expose the patient to radiation.
DEXA scans are bone density scans that are utilized to evaluate for osteoporosis (a progressive bone disease characterized by decreased bone mass and density) or osteopenia (low bone density and precursor to osteoporosis).
Bone scans are utilized for looking for bone abnormalites that trigger the bone healing process. One type of bone scan is a nuclear bone scan and is often recommended for patients who may have inflammation, disorders or suspected tumors of the bones. This type is referred to a functional scan because it looks at bone metabolism using nuclear medicine injected into the patient. A nuclear bone scan will show up as abnormal uptake of the nuclear medicine where bone is fractured, contains a tumor or has sustained injury.