Neuroradiology

 
UC San Diego neuroradiologists work closely with neurologists, neurosurgeons, and other specialists to provide the most accurate diagnoses and offer patient-centered treatment plans. Our ongoing collaborative research projects and teams of physicists ensure that we remain at the forefront of Neuroradiology. 

We provide clinical services in six areas of specialization:

Brain imaging

Neuroradiology Brain Imaging protocols incorporate advanced imaging techniques along with standard MRI and CT scans. Procedures we offer include CT, CT angiography, CT perfusion, Brain MRI with diffusion, MR angiography, MR perfusion including arterial spin-labeling (ASL), and acute stroke interventions.

  • Stroke - Our acute Stroke Code protocol includes a Head CT, CT angiography, and often MRI with ASL perfusion to detect acute cerebral ischemia and hemorrhage, and to identify any blockage of arteries or areas of the brain with deficient blood supply. If the CT scan is normal, we often recommend a Brain MRI with diffusion imaging, our most sensitive technique for detecting acute stroke. Our CT and MRI services are located near to the Emergency department to ensure rapid imaging diagnosis. If clots or vessel occlusion are detected, our Neuroradiology Interventional team can reopen the arterial to minimize damage to the brain.
  • Epilepsy - Epilepsy patients are imaged on our 3T magnet to obtain high resolution images of the temporal lobes, common anatomic sites for seizures. Patients with potential surgical lesions are referred for MEG (magnetoencephalography) to accurately localize the seizure focus for the surgeons. In addition, Functional MRI and DTI (diffusion tensor imaging) with tractography identify critical brain structures to help guide the epilepsy surgery.
  • Oncologic - Oncologic imaging includes MRI in conjunction with spectroscopy and brain perfusion to diagnose tumors preoperatively and to follow patients’ response to treatments. A team approach is critical in caring for complex oncology patients. Neuroradiology works closely with Neuro-oncology and Neurosurgery.
  • Infection - Both CT and MRI are used to search for brain infections. Diffusion-weighted imaging and MR spectroscopy help to distinguish infections from other diseases of the brain. In addition to extensive experience diagnosing common brain infections, we have many collaborative research projects investigating opportunistic brain infections in patients who are immunocompromised due to viral infections or treatments for cancer.
  • Neurodegenerative - Neurodegenerative conditions are evaluated with 3D volumetric MRI to measure specific brain structures related to these diseases. UC San Diego is actively involved in national research projects on the diagnosis and treatment of Alzheimer’s disease and other neurodegenerative conditions.
  • Trauma - UC San Diego is a Level I trauma center. Radiology is closely aligned with our Emergency department, and CT and MRI are available 24 hours a day. Trauma patients routinely receive emergent high-resolution CT scans to detect fractures, intracranial hemorrhage, and brain injuries. CT angiography is available to detect any vascular damage. High-field MRI and MEG are also offered to assess traumatic brain injury that may not be visible on CT. UCSD has the only MEG in San Diego.

Spine Imaging

Multiplanar, high-resolution CT is used to evaluate the bony structures of the spine. MRI provides exquisite detail of the spinal cord, intervertebral disks, and soft tissue structures around the entire spine.

  • Cervical Spine
  • Degenerative
  • Thoracic Spine
  • Lumbosacral Spine
  • Oncologic
  • Trauma

Head & Neck Imaging

UCSD Moores Cancer Center is the only National Cancer Institute (NCI) designated Comprehensive Cancer Center in San Diego. As part of the multidisciplinary care team, UCSD Neuroradiologists review all imaging of patients being treated for head and neck cancers, and locally advanced thyroid and skin cancers.

We partner with our expert surgical colleagues in Head and Neck surgery to evaluate patients with conditions affecting the sinuses, hearing and balance, voice and swallowing, cranial nerve symptoms, skull base and neck trauma, and to provide imaging for surgical guidance and reconstruction. 

We provide CT and MR imaging of the orbits for treatment and surgical planning for patients with eye disease treated at the UCSD Shiley Eye Institute, the only academic eye center in our region.

Our faculty have authored key textbooks regarding head and neck imaging, and contribute to the field through service to the American Society of Head and Neck Radiology, the American Society of Neuroradiology, and the American College of Radiology, as well as participating in clinical trials and imaging protocol development for diseases of the head and neck.

Fetal MRI

Ultrasound is a powerful tool for evaluation in pregnancy. When ultrasound images suggest  an abnormality of the developing fetal brain or spine, MRI can provide additional detail regarding the developing structures to allow the perinatologist to plan with the family. UCSD Neuroradiologists monitor and adapt fetal MRI to the areas of concern and serve as a local resource for advanced fetal imaging in the region.

Magnetoencephalography (MEG)

We have one of only 20 MEG scanners in the country. We use an Elekta Neuromag Vector View 306 Channel MEG combined with 128 Channell EEG machine in a 6 layer shielded room. Procedures we offer include Median Nerve, Tibial Nerve, Somatosensory, N-back test, and Dichotic listening test.

We can examine patients for a variety of abnormalities, including epilepsy. Ours is the primary site where MEG is used to detect physiological evidence of traumatic brain injury. Conventional MRI detects traumatic brain injury only 10% of the time. MEG looks for slow wave measurements that can allow invisible brain injury to be visible. The ultra-sensitive MEG can spot damaged brain cell tissue and therefore find traumatic brain injury 85% of the time. It can help neurologists determine if a patient is suffering from traumatic brain injury or post traumatic stress disorder, each requiring very different treatments.

Advanced Imaging
Advanced imaging is used routinely for evaluating patients with suspected disease of the central nervous system. They improve detection of lesions, help characterize abnormalities, and guide treatment of disease.

  • CT and MR Angiography (CTA and (MRA) provide images of the arteries and veins of the brain and neck. They detect injury, stenosis or occlusion of the vessels. CTA and MRA also diagnose other vascular diseases, such as aneurysms and arterial venous malformations.
  • Diffusion weighted MRI is exquisitely sensitive for detecting acute stroke. It is also used to diagnose brain abscess and to assess the cellular density of brain tumors.
  • Diffusion Tensor Imaging (DTI) detects damage to the white matter of the brain. It is also used to map special white matter fiber tracts before surgery.
  • Functional MRI (fMRI) interrogates the activity of specific brain structures. Aside from being a powerful research tool for studying language and psychiatric diseases, it is used clinical to identify eloquent areas of the brain to guide the surgeon and make brain surgery safer and more successful.
  • Perfusion is performed with either CT or MRI to evaluate blood flow to the brain. In patients with suspected stroke, perfusion can detect areas of the brain that are not getting enough blood. Perfusion is also used to grade the malignancy of brain tumors, and in follow up, to distinguish radiation change from recurrent tumor.
  • MR Spectroscopy measures the chemistry of the brain to help characterize brain tumors and to check for any residual or recurrent disease after treatment. Spectroscopy is also very sensitive for detecting brain ischemia in infants.

Division Faculty