What am I Looking at? A Neuro-Imaging Primer for the C-L Psychiatrist on How to Read Imaging and Make Clinical Correlations

As C-L psychiatrists straddle the world of medicine and psychiatry, we must stay abreast of updates in medicine and maintain clinical skills that keep us relevant in the hospital and in outpatient integrated care clinics. Because of the overlap between psychiatry and neurology, many C-L psychiatrists do neurological exams during their evaluations and should have a working knowledge of neuroradiology to think through diagnoses and make recommendations. This session presents a review of neuroimaging modalities (CT, CTA, MRI, MRA); the radiologic neuroanatomy relevant to psychiatry; the correlation of clinical presentations and different anatomical regions of the brain; and findings on imaging.

The session will review neuroimaging modalities including CT and MRI of the head with and without contrast, CTA and MRA and the indications for recommending imaging studies in different clinical presentations. We will present a standardized technique on how to review imaging and identify the most common neuroanatomy. Correlates of the neuroanatomy to clinical presentation including psychiatric and neurologic symptoms will be solidified by reviewing with clinical cases and their imaging.

Examples of cases include: 1) Imaging of a patient with frontal lobe injury and review of different areas of the of prefrontal cortex; 2) Review of imaging of 5 different patients with strokes in order to teach pertinent circulation, neuroanatomy and sequelae of aphasia and psychiatric symptoms; 3) Review of unusual cases such as an subdural hematoma and a meningioma both resulting in mania, and imaging of patients with depression with various radiological findings 5) Review of serial MRIs of patients with neurocognitive disorder and discussion of “age appropriate” findings.

Dr. Meguid, a neuropsychiatrist, will moderate and introduce the session. The session will start with a 30-minute primer on the basics of neuroradiology and instructions on how to read CT and MRI of the brain lead by Dr. Bhairav from the department of radiology. For the case based portion of the workshop (45 minutes), Drs. Emery and Posada (inpatient CL psychiatrists) will engage the audience in an interactive session using a polling software. Using open-ended and multiple choice questions, the attendees will be asked to identify different areas of the brain and correlate neuroimaging with the associated neurological or psychiatric functions/symptoms of the cases. The last 15 minutes of the workshop, will be a Q&A with the speakers.