Neuroradiology in psychiatry

This article explored methods of brain imaging as they relate to the practice of psychiatry. In particular, technical aspects and clinical applications of CAT scanning are reviewed, and some neurologic conditions that may masquerade as psychiatric illness are considered. Suggested guidelines for CAT scanning in psychiatric patients are put forth, and implications of recent research findings in psychiatric disorders are discussed. In closing, we offer the following caveat: As "psychiatric" symptoms may be the earliest sign of structural CNS disease, the psychiatrist may be the first physician to evaluate patients with neurologic abnormalities. Because even the neurologic consultant may not be alert to the possibility of psychiatric symptoms alone heralding CNS pathology, the decision to augment the clinical impression with neuroradiologic or other brain imaging adjuncts (and to choose among them) may rest solely with the psychiatrist. Of these adjuncts, CAT scanning is almost always the most conclusive and reliable.