“NORMAL LOOKING ABNORMAL BRAIN: A REVIEW OF ABNORMALITIES IN BLINDSPOTS OF CT BRAIN”.

Maria rauf

Abstract


ABSTRACT:

Brain imaging techniques provide the ability to non-invasively map the structure and function of the brain. Though CT is the earliest, fastest and convenient first line modality to evaluate the abnormality within the normal looking brain. There are certain blind spots where pathological findings are commonly missed along with the subtle radiological findings which are commonly misinterpreted by the radiologist, especially the one with the limited experience.

 

METHOD: Aim of our study is to determine such blindspot areas and enlist the cases encountered at Shifa International Hospital which were most commonly missed / misinterpreted by retrospectively reviewing 1200 consecutive CT brain over a period of one year from June 2018 to june 2019.

 

RESULTS: Out of these, 150 CTs showed nearly missed /misinterpreted findings which are further characterized into; traumatic ( fractures, subdural and subarachnoid hemorrhage) 61/150 scans (40.7%); ischemic (hyperacute infarcts) 44/150 scans (29.3%); vascular (aneurysms and dural sinus thrombosis) 30/150 scans (20.7%); neoplastic (meningioma, glomus tumor, CP angle schwannoma) 14 /150 scans (9.3%) and miscellaneous including infections 1/150 scans (less than 1 %).

 

CONCLUSION: Knowledge of anatomical features of these blind spots and use of appropriate window width and level settings while evaluating CT images are important for avoiding false negative results in a normal looking brain. Also systematic review of the blind spots using comprehensive check list is key to avoid such errors.

 

KEYWORDS: blindspot, CT, window width, trauma, vascular.


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