Deck 16: Central Nervous System

Question 1

A patient is sent to the nuclear medicine department to have a CNS ¹¹¹In-DTPA study performed to

A)assess integrity of the blood-brain barrier.
B)assess cerebral spinal flow dynamics.
C)localize seizure focal points.
D)assess brain death.

Answer 1

assess cerebral spinal flow dynamics.

Question 2

Which radiopharmaceutical is used for ictal SPECT imaging?

A)(^99m)Tc-HMPAO
B)(¹¹¹)In-labeled DTPA
C)(^99m)Tc-pertechnetate
D)(¹⁸)F-FDG

Answer 2

(^99m)Tc-HMPAO

Question 3

A patient is scheduled for a ^99mTc-HMPAO brain scan.The technologist must remember that ^99mTc-HMPAO

A)only crosses a compromised blood-brain barrier and in proportion to blood flow.
B)remains trapped in the subarachnoid space for 20 minutes after injection.
C)acts as an analog to thallium-201.
D)remains trapped in the brain in proportion to cerebral blood flow at the time of injection.

Answer 3

remains trapped in the brain in proportion to cerebral blood flow at the time of injection.

Question 4

A patient is scheduled for a SPECT brain procedure.Before the radiopharmaceutical is administered, the patient should

A)be well hydrated.
B)be placed in a quiet, dimly lit room.
C)have received Lugol's solution.
D)have undergone a CT scan of the brain.

Question 5

The most commonly encountered radiopharmaceutical for imaging CNS tumors is

A)(^99m)Tc-ECD.
B)(¹⁸)F-FDG.
C)(¹⁸)F-thymidine.
D)(¹¹)C-methionine.

Question 6

All of the following may be spared from the effects of Alzheimer's disease, EXCEPT

A)thalamus.
B)basal ganglia.
C)visual cortex.
D)frontal lobe.

Question 7

Acetylcholine is

A)excitatory in the brain and inhibitory in the heart.
B)inhibitory in the brain and excitatory in the heart.
C)excitatory in the brain and excitatory in the heart.
D)inhibitory in the brain and inhibitory in the heart.

Question 8

All of the following are true regarding SPECT or PET functional brain imaging on patients with neurodegenerative disease, EXCEPT

A)may show structural changes before anatomic imaging.
B)may identify those patients with mild cognitive impairment who are more likely to progress.
C)may slow the progression of certain forms of neurodegenerative disease.
D)certain patterns of radiopharmaceutical distribution are suggestive for specific types of dementia.

Question 9

A patient arrives at a nuclear medicine department for a CSF shunt evaluation.The technologist readies the patient for an injection into the

A)antecubital vein.
B)shunt reservoir.
C)subarachnoid space.
D)shunt tubing.

Question 10

The intrathecal injection for CSF imaging allows for the dose to be

A)administered during a seizure.
B)administered into the subdural space.
C)administered into the subarachnoid space.
D)administered into the spinal cord.

Question 11

To produce high-resolution, low-noise images, the resolution in the images on a SPECT brain scan, the technologist will

A)use the electronic zoom.
B)use pre- and postprocessing filters.
C)perform the attenuation correction outside the ellipse.
D)use a transmission scan.

Question 12

Which form of dementia demonstrates on SPECT with hypoperfusion and PET with reduced glucose metabolism in the frontal and temporal lobes with sparing of the remaining cerebral cortex?

A)Alzheimer's disease
B)Parkinson's disease
C)Frontotemporal dementias
D)Lewy body dementia

Question 13

The images in a cerebrospinal fluid leak study show an initial wide segmental appearance with no activity in the basal cisterns at 2 to 3 hours after injection.The technologist should

A)count the pledgets.
B)continue routine images at 6, 24, and 48 hours after injection.
C)prepare for a reinjection.
D)have the patient change position and then repeat the image.

Question 14

Following a nuclear medicine study to assess CSF dynamics, the patient should be instructed to

A)remain in a horizontal position for 2 hours after injection.
B)drink plenty of fluids and void urine frequently.
C)keep distance between themselves and children for 2 days after injection.
D)not have any radiographic brain studies for 1 week.

Question 15

A patient is sent to the nuclear medicine department for a CSF study.The technologist prepares for the radiopharmaceutical injection by

A)dimming the lights in the procedure room.
B)setting up a three-way stop cock with a saline flush.
C)setting up for an intrathecal injection.
D)observing the patient for seizures.

Question 16

All of the following are true about acetazolamide or its use in brain imaging EXCEPT

A)it acts as a vasodilator.
B)it causes increased perfusion.
C)it serves to localize an epileptogenic focus.
D)it improves diagnostic accuracy in cerebral vascular disease.