Name: Tan, Andrea Camille P.

Date: July 2,
2010
Section: BSN 140

DIAGNOSTIC EXAMINATIONS

Neuroimaging has evolved tremendously, providing psychiatrists with unprecedented

information about brain structure and function. Computer tomographic (CT) scanners, the first
widely used neuroimaging devices, allowed assessment for structural brain lesions such as
tumors or strokes. Magnetic resonance imaging (MRI) scans, developed next, distinguish gray
and white matter better than CT scans did and allowed visualizations of smaller brain lesions as
well as white matter abnormalities.

Primary observation of structural and functional brain imaging in neuropsychiatric

disorders has not only contributed to a greater understanding of the pathophysiology of
neurological and psychiatric illnesses, but also can help practicing clinicians in difficult
diagnostic situation.

TYPES OF NEUROIMAGING USES

A. Specific Techniques
1. Computed Tomography  In 1972, CT scanning revolutionized diagnostic
(CT) Scans neuroradiology by permitting imaging of the
brain tissue in live patients.
 Most widely available and convenient imaging
tools available in clinical practice.
 Takes series of head X-ray pictures from all
vantage points, 360˚ around a patients head.
 Amount of radiation that passes through, or is
not absorbed, from each angle is digitalized and
entered into a computer.
 The computer assigns a specific density to each
point within the head and displays these data as a
set of 2D images.
 Allows mental reconstruction of the shape of the
brain.
 2. Magnetic Resonance  Entered clinical practice in 1982 and soon
Imaging (MRI) Scans became the test of choice for clinical
psychiatrists and neurologist.
 Technique does not rely on the absorption of x-
rays but is based on nuclear magnetic
resonance (NMR).
 Principle of NMR is that the nuclei of all atoms
are thought to spin about an axis which is
randomly oriented in space.
 When atoms are placed in a magnetic field, the
axes of all odd-numbered nuclei align with the
magnetic field.
 The axis of the nucleus deviates away from the
magnetic field when exposed to a pulse of
radiofrequency electromagnetic radiation
oriented at 90 to 180˚ to the magnetic field.
 MRI scanners collect the emissions of
individual, realigning nuclei and use computer
analysis to generate a series of 2D images that
represent the brain.
 Images may be in the axial, coronal, or sagittal
planes.
 The most abundant odd-numbered nucleus in
the brain belongs to hydrogen.
B. Neuropsychological Probes 
 Neural electrical activity consists of patterned
changes in electrical potential across cell membrane.
 Individual cells generate membrane potentials that
1.Electroencephalography can be detected only within a few micrometers of the
cell, but assemblies of brain cells that fire
synchronously may generate potentials on the order
of microvolts, which can be detected through the
skull and skin with an array of scalp electrodes.
 Regional variation in electrical potential across the
scalp forms the basis of EEG, which is the recording
of the electrical activity of the brain.
 EEG is used in clinical psychiatry principally to
evaluate the presence of seizures, particularly
temporal lobe or frontal lobe seizures, which may
produce complex behavior.
 The principal source of EEG activity is the electrical
potential of the brain.