Neuroimaging
Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Increasingly it is also being used for quantitative research studies of brain disease and psychiatric illness. Neuroimaging is highly multidisciplinary involving neuroscience, computer science, psychology and statistics, and is not a medical specialty. Neuroimaging is sometimes confused with neuroradiology.
This article is about imaging. For imagery and creating maps, see Brain mapping and Outline of brain mapping.Neuroimaging
Indirectly (directly) image structure, function/pharmacology of the nervous system
Neuroradiology is a medical specialty and uses non-statistical brain imaging in a clinical setting, practiced by radiologists who are medical practitioners. Neuroradiology primarily focuses on recognising brain lesions, such as vascular disease, strokes, tumors and inflammatory disease. In contrast to neuroimaging, neuroradiology is qualitative (based on subjective impressions and extensive clinical training) but sometimes uses basic quantitative methods. Functional brain imaging techniques, such as functional magnetic resonance imaging (fMRI), are common in neuroimaging but rarely used in neuroradiology. Neuroimaging falls into two broad categories:
Indications[edit]
Neuroradiology often follows a neurological examination in which a physician has found cause to more deeply investigate a patient who has or may have a neurological disorder.
Common clinical indications for neuroimaging include head trauma, stroke like symptoms e.g.: sudden weakness/numbness in one half of body, difficulty talking or walking; seizures, sudden onset severe headache, sudden change in level of consciousness for unclear reasons.
Another indication for neuroradiology is CT-, MRI- and PET-guided stereotactic surgery or radiosurgery for treatment of intracranial tumors, arteriovenous malformations and other surgically treatable conditions.[5][6][7]
One of the more common neurological problems which a person may experience is simple syncope.[8][9] In cases of simple syncope in which the patient's history does not suggest other neurological symptoms, the diagnosis includes a neurological examination but routine neurological imaging is not indicated because the likelihood of finding a cause in the central nervous system is extremely low and the patient is unlikely to benefit from the procedure.[9]
Neuroradiology is not indicated for patients with stable headaches which are diagnosed as migraine.[10] Studies indicate that presence of migraine does not increase a patient's risk for intracranial disease.[10] A diagnosis of migraine which notes the absence of other problems, such as papilledema, would not indicate a need for radiological investigations.[10] In the course of conducting a careful diagnosis, the physician should consider whether the headache has a cause other than the migraine and might require radiological investigations.[10][11]
Advantages and concerns of neuroimaging techniques[edit]
Functional Magnetic Resonance Imaging (fMRI)[edit]
fMRI is commonly classified as a minimally-to-moderate risk due to its non-invasiveness compared to other imaging methods. fMRI uses blood oxygenation level dependent (BOLD)-contrast in order to produce its form of imaging. BOLD-contrast is a naturally occurring process in the body so fMRI is often preferred over imaging methods that require radioactive markers to produce similar imaging.[33] A concern in the use of fMRI is its use in individuals with medical implants or devices and metallic items in the body. The magnetic resonance (MR) emitted from the equipment can cause failure of medical devices and attract metallic objects in the body if not properly screened for. Currently, the FDA classifies medical implants and devices into three categories, depending on MR-compatibility: MR-safe (safe in all MR environments), MR-unsafe (unsafe in any MR environment), and MR-conditional (MR-compatible in certain environments, requiring further information).[34]