Head and neck

MRI of the brain

Magnetic resonance imaging · Axial section · Brain

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For a first-year student this is a neuroanatomy specimen that happens to be alive. You are not being asked for a diagnosis. You are being asked to orient the section, name the lobes, find the ventricles and the falx, and know why grey and white matter differ in signal. Say the modality first: on a radiograph bone is white, but MRI is not a density image at all.

MRI of the brain — Magnetic resonance imaging, Axial section

Magnetic resonance imaging · Axial section · © MedpulseIq.com

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Name the anatomy first

The plane of the section and the side markers
The falx cerebri in the midline
Both lateral ventricles and the third ventricle
Grey matter at the cortex and deep nuclei, white matter between
The symmetry of the two hemispheres

Do not confuse it with

A computed tomogram
Computed tomography is a density image in which bone is uniformly bright and the skull vault is conspicuous; magnetic resonance gives far better grey-to-white contrast and cortical bone gives little signal.
A coronal section
A coronal section shows the vault above and the skull base with the temporal lobes below; an axial section shows a roughly oval outline with the ventricles side by side.

Examiner trap

Treating the image as though bone were white. Magnetic resonance is not a density image, and saying so at the start shows you know which modality you are holding.

Memory hook

Name the modality, the plane and the side before you name anything inside the head.

Senior’s 30-second takeaway

MRI of the brain — the whole bench in four lines. Read this on the way in.

If you see this: A soft-tissue image with excellent grey-to-white contrast · A central falx with symmetrical hemispheres · Ventricles of normal size
If asked to identify it: This is an axial magnetic resonance image of the brain with normal appearances.
If asked one more: By convention the patient's left is displayed on the right of the image.
If asked why it matters: Loss of grey and white matter differentiation and effacement of the sulci are among the earliest signs of swelling.

Then stop. Let the examiner ask the next question.

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Senior’s 30-second takeaway

Before you comment on anything