Neuroradiology Back to the Future: Brain Imaging

E.G Hoeffner,S.K Mukherji,D.J Quint,A Srinivasan

doi:10.3174/ajnr.a2936

Abstract

The beginning of neuroradiology can be traced to the early 1900s with the use of skull radiographs. Ventriculography and pneumoencephalography were introduced in 1918 and 1919, respectively, and carotid angiography, in 1927. Technical advances were made in these procedures during the next 40 years that lead to improved diagnosis of intracranial pathology. Yet, they remained invasive procedures that were often uncomfortable and associated with significant morbidity. The introduction of CT in 1971 revolutionized neuroradiology. Ventriculography and pneumoencephalography were rendered obsolete. The imaging revolution continued with the advent of MR imaging in the early 1980s. Noninvasive angiographic techniques have curtailed the use of conventional angiography, and physiologic imaging gives us a window into the function of the brain. In this historical review, we will trace the origin and evolution of the advances that have led to the quicker, less invasive diagnosis and resulted in more rapid therapy and improved outcomes.

Highlights

Efforts to image the CNS began with skull radiographs shortly after Roentgen’s discovery of x-rays
Schuller8 was aware of the difficulty in diagnosing soft-tissue changes via skull radiography, while others noted that skull radiographs were most useful in tumors with calcification or bone destruction
Even in cases in which abnormalities were seen on skull radiographs, they were mainly in advanced stages of disease (Fig 1)

Summary

Introduction

Efforts to image the CNS began with skull radiographs shortly after Roentgen’s discovery of x-rays.1-3 In the early 20th century, contrast studies of the brain, by using air for contrast, were developed with the introduction of ventriculography and pneumoencephalography.4,5 Shortly thereafter, cerebral angiography was described.

Results

Conclusion