s5260205

7+ Year Member
Apr 5, 2010
620
304
Status
Been shadowing a neurologist both inpatient and outpatient this summer. Just wondering how would a medical student begin to approach learning head and neck imaging (CTA/CTP/CT, MRI/MRI, etc.), seeing how many of the residents and some MS4 (and of course attendings) that I saw are quite proficient in interpreting these imagings. Is this a skill students develop as they go through rotations in 3rd/4th years or is it something we have to sit down with a textbook to learn?
 

Gnocchi Monster

5+ Year Member
May 27, 2010
71
10
Status
Medical Student
over the years I've compiled several very helpful web resources for imaging:

1. headneckbrainspine- http://headneckbrainspine.com/web_flash/newmodules/Brain MRI.swf. I believe this does not have CTA neck, nor CTP, but otherwise a fantastic resource.
2. Radiology masterclass- http://www.radiologymasterclass.co.uk/tutorials/ct/ct_brain_anatomy/ct_brain_anatomy_skull. phenomenal basic CTH with really good mouseover overlays.
3. UVA intro to CTH-https://www.med-ed.virginia.edu/courses/rad/headct/index.html. I like the radiology masterclass better, but some may prefer this format
4.radiology assistant-http://www.radiologyassistant.nl/en/p420ccf62df7c1/click-for-more-information.html. I really like these short sections on various pathologies and associated imaging. Short and to the point

In my experience, I have not yet met a medical student who knows much/any about perfusion studies, although it is not particularly difficult if you understand the concept of infarct and tissue at risk. If you understand CTH and the normal anatomy and what to look for in pathological cases, you will be a in a great spot come residency. Similarly a basic understanding of MRI brain DWI, ADC,GRE,FLAIR sequences as well as a general knowledge of head and neck vessels is more than enough for now. You'll have plenty of time to learn more in residency.
 

kchan99

15+ Year Member
Apr 21, 2004
305
86
Maryland
Status
Attending Physician
At this point, learn neuroanatomy (more than recognizing lobes and major subcortical nuclei) and cerebrovascular anatomy, understanding neuroimaging modalities (US, CT, MRI, hybrid imaging (PET/CT, PET/MRI), DSA), recognize MRI sequences, and normal CT/MRI. Radiopaedia is another good resource. Even though you may be interested in neurology, don't forget body imaging, such as chest Xrays, which you'll see during prelim medicine. You'll be looking at chest Xrays for various reasons before a prelim read is available from radiology. For chest Xray, there's Felson's.

Please keep in mind that neurology is not all about neuroradiology. Imaging is not a substitute for the neuro exam.
 
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DrZed

Do No Harm
Feb 12, 2013
119
15
Status
I agree that imaging is not a substitute for a neuro exam, but need to read it is still critical. Honestly, if you're a med student, find an attending or resident and have them go over images with you. Look at a bunch on your own. Eventually you'll get the hang of it. Make sure you understand the modalities too so you can understand what you're looking at and why you're looking for it. I remember starting 3rd year and being complete **** with images. After a good neurosurg rotation where I had to read every single patient's images to my attending, I got pretty darn good.
 
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