Central Nervous System Procedures - NMTCB Exam Review Questions and Answers 100% Verified

Central Nervous System Procedures -
NMTCB Exam Review
BBB Imaging:
- ABnormal Distrabution? - ✔️✔️activity in Carotids BUT COMPLETE Absence in
Middle Cerebral and Anterior Cerebral Arteries --- due to increased intracranial pressure
caused by any of the clinical indications

Brain Perfusion Imaging:
- Clinical Indicaitons? (5) - ✔️✔️- CVD, Cerbrovascular Disease (acute stroke, transient
ischemic attacks)
- Dementia (alzehimers, multi-infarct)
- Psychiatric Diosorders (deppresion, schizophrenia)
- Seizure Disorders (focal site of epilepsy)
- Head trauma

Brain Perfusion Imaging:
- what type of image is it usually?
- whats the exception? - ✔️✔️- Usually Planar
- Brain Death is exception



BBB Imaging:
-clinical indications? (4) - ✔️✔️- primary or metestatic disease
- Intracranial inflammatory disease
- cerebrovascualr disease
- head trauma

BBB Imaging:
- NOT Preferred Radiopharm? - ✔️✔️- Pertechnetate - bc taken up in choroid plexus

BBB Imaging:
- Preferred Radiopharm? (dose? how is it inj (IV Obvi but..))
- why (4) - ✔️✔️99m Tc - Pentetate (DTPA) (15-30mCi bolus inj)
- Rapidly cleared
- increase target to non target ratio
- lower radiation exposure
- does not accumulate in choroid plexus

BBB Imaging:
- Imaging type/s and time?

, - image from where to where? - ✔️✔️Can be - planar, 3-phase, statics
-performed 30min-3hr post inj
- image from top of head to neck (anterior)

BBB Imaging:
- Normal Distrabution? (time and locations!) - ✔️✔️6 sec- symmetrical flow in Carotif
Arteries and Anterior Cerebral Artery

15 sec- Super Saggital Sinus (blood in venous system)

Delayed statics- activity around skull border and mast sinus

Brain Perfusion Imaging:
- what 2 radiopharms are used ? - ✔️✔️- 99m Tc Exametazine (HMPAO)
- 99m Tc Bicisate (ECD)

Brain Perfusion Imaging:
Radiopharms:
- lipid or water soluble? - ✔️✔️- BOTH are lipid soluble, and can cross undamaged
BBB

Brain Perfusion Imaging:
Radiopharms:
- Can they cross back into circulation after crossing BBB? - ✔️✔️- NO, do not cross
back

Brain Perfusion Imaging:
Radiopharms:
- is uptake proprtional to blood flow? - ✔️✔️- YES. uptake is proprtional to blood flow

Brain Perfusion Imaging:
Radiopharms:
- When can imaging be done?
- ECD
- HMPAO - ✔️✔️- ECD - 15-20min
- HMPAO - 60min
- UP TO 6 hr after inj

Brain Perfusion Imaging:
Radiopharms: (BOTH)
- DOSE? - ✔️✔️10-20 mCi

Brain Perfusion Imaging:
ptnt prep procedure (BOTH)
- (3) - ✔️✔️- butterfly needle in AC vein