Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

What imaging technique is recommended for assessing increased intracranial pressure (ICP) when contrast is not used?

1. CT without contrast

2. MRI without contrast

3. MRI with gadolinium

4. CT with contrast

The correct answer is: MRI with gadolinium

The recommended imaging technique for assessing increased intracranial pressure (ICP) when contrast is not used is a CT without contrast. This method is preferred because it allows for quick, effective visualization of the brain and can reveal conditions such as hemorrhage, tumors, or edema that may be contributing to increased ICP. A non-contrast CT scan can be performed rapidly, which is crucial in emergency situations where timely diagnosis is essential for patient management. In cases where MRI without contrast is mentioned, it is important to note that while MRI can provide detailed images of brain structures and pathologies, it is not always the first-line imaging modality for acute presentations, especially due to longer scan times and potential patient movement during the exam. Using an MRI with gadolinium or CT with contrast is not appropriate when the requirement stipulates that contrast should not be used. These methods would provide additional information that may not be available from a non-contrast approach and could complicate the clinical scenario when the emphasis is on initial, rapid assessment of ICP without the risks or delays associated with contrast agents. Therefore, the choice of CT without contrast aligns directly with the clinical need to quickly evaluate for causes of increased ICP without the influence of contrast material.