This is nice presentation covers most of imporant intrancranial ( Brain) infection with many ct mri images . This presentation also includes cns (brain) manifestation of COVID-19 latest hot topic. This is very helpful for radiologist or radiology resident. Thanks.
Imaging evaluation of spectrum of infective pathologies of CNS including encephalitis,meningitis,abscesses,congenital pathologies and hiv associated conditions etc.
This presentation briefly summarizes pathophysiology, clinical features, diagnosis and treatment of different types of tuberculosis of brain and spinal cord.
Radiology Spotters collection by Dr Pradeep. Nice collection Radiology spotters mixed collection ppt made by or collected by Dr. Pradeep, this is a collection of confusing spotter and very important spotter commonly asked in exams, our references is radiopaedia, learning radiology and Aunt Minnie.. Thanks
Radiology Spotters mixed Bag Collection for post graduates student .PPTDr pradeep Kumar
Radiology Spotters collection by Dr Pradeep. nice collection of radiology spotter made by or collected by Dr. Pradeep, this is a collection of confusing spotter and very important spotter commonly asked in exams, our references is radiopaedia, learning radiology and Aunt Minnie.. Thanks.
Skeletal dysplasia musculoskeletal radiology is very concise and it cover the all-important topic of skeletal dysplasia with their characteristic feature and radiological findings with a proper radiographic image. Starting from classification and approach. It includes nosology classification. Thanks.
Abnormal abdominal CT is best powerpoint presentation for radiologist, radiology resident and gastroenterologist, this include pancreatitis, all abdominal trauma grading with systemic manner. Thanks
Role of hrct in interstitial lung diseases pk uploadDr pradeep Kumar
Role of hrct in interstitial lung diseases pk , This is best powerpoint slides presentation including Latest American thoracic society and fleishners society guidelines . this includes radiographic images a well HRCT chest findings of various ILD. This will help alot for md pg radiology resident and radiologist. Thanks
Solitary pulmonary nodules radiology ppt is very good power point presentation from various source radiology assistant and latest guidelines. this power-point also includes many sign with multiple xray, ct and mri images. this will help alot. Thanks.
Jaw lesion radiology ppt ppt . This powerpoint presentation includes important anatomy, radiographs and important pathology of jaw lesion with its imaging feature as well as its Xray ct mri image. This will help alot. this will help for radiology resident as well as ent resident and event dentist.
Skull base tumors & perineural spread radiology pptDr pradeep Kumar
Skull base tumors & perineural spread radiology ppt This powerpoint presentation includes important anatomy and important pathology of skull base lesion with its imaging feature as well as its ct mri image. This will help alot. this will help for radiology resident as well as ent .
Salivary gland imaging radiology ppt . This powerpoint presentation includes important anatomy and important pathology of salivary gland with its imaging feature as well as its ct mri image. This will help alot. this will help for radiology resident as well as ent .
MRI anatomy of ankle radiology ppt pk is nice presentation that covers cross sectional anatomy as well as relevant anatomy from standard radiology book like CT MRI whole body by Hagga . cross section of mri is taken from mrimaster.com. This will help for radiology resident as well radiographers.
Congenital neck mass radiology pk final is very good power point presentation for radiologist, radiology resident, student and even ent surgeon or resident doctor.. Every disease of neck lesion is properly describe with multi usg, ct and MRI images. this will help a lot. thanks.
Imaging of paranasal sinuses (including anatomy and varaints)pk1 pdf pptDr pradeep Kumar
This is very good powerpoint presentation of imaging anatomy and variants of paranasal sinuses and imaging pathology as well as multiple pathological imaging findings and images.it will helps for radiologist and radiology resident and even ent resident. our references is CT and mri whole body by Haaga and various internet sources. THANKS.
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This slide includes various CT protocol , liver ct triple phase protocol , with important findings, this power-point presentation help a lot for radiologist, radiology resident, radiographers, technician. Thanks.
this power-point presentation includes knee and ankle MRI anatomy with cross sectional axial saggital and coronal views images. this also includes some pathology. this slide will help a lot for radiologist, radiographers, technician radiology resident, thanks.
This presentation include biliary anatomy ,indication, contraindication post op care of percutaneus transhepatic biliary drainage with important technique. and advantage and disadvantage of different technique. This is important for radiologist, radiographers, intervention radiologist radiology resident. Thanks
This power-point presentation is very important for radiology resident radiologist and radiographers and technician. this includes principles, technique , biological effects of radiation and how to protect, whats should normal radiation dose with latest update. This slide also includes ALARA PRINCIPLE thanks.
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Barium meal ppt presentation is very important for radiology resident , radiologist and radiographers. this slide contents lots of barium image and technique, position, indication and modification and lots of information. this presentation help alot thanks .
Sellar, Suprasellar and Pineal tumor final pk .pptDr pradeep Kumar
this is very good presentation slide for radiologist and radiology resident. our references is authentic and most are from osborn brain imaging 2nd edition. This deal with sellar, suprasellar and pineal tumor . This help alot. thanks
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
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2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
3. Congenital/neonatal infections
Causative agents-
1. TORCH agents-Toxoplasma, Rubella, CMV, HSV
2. HIV , varicella , enteroviruses and Syphilis
Routes
Transplacental – toxoplasmosis, most viruses
Ascending cervical infections – bacteria
During birth – HSV II
Can result in
Developmental malformations
Encephaloclastic lesions (brain destruction)
Dystrophic calcifications
4. Imaging modalities
• CT- plain and contrast
• MRI- T1 , T2 axial saggital and coronal ,T2/ FLAIR- for
vasogenic edema
DWI/ADC- For restriction and T2 GRE and SWI for
haemorrhage and calcification
5. CMV
• Most common congenital CNS infection (DNA; Herpes virus)
• Can also cause SNHL, cardiac anomalies, hepatosplenomegaly
• Predilection for periventricular subependymal germinal matrix
• Widespread periventricular tissue necrosis and subsequent dystrophic
calcification.
• Other sites- cerebral white matter, cortex, cerebellum and brainstem
11. Axial unenhanced CT image
reveals a peripherally
calcified lesion (arrow) in
the right caudate head that
is a sequela of previous
toxoplasmosis infection. The
low-attenuation mass lesion
with surrounding edema in
the region of the left basal
ganglia is from a new focus
of toxoplasmosis.
12. RUBELLA
•Inhibits proliferation of immature
undifferentiated progenitor cells
in germinal matrix.
•Before 12 wks- fetal demise,
stillbirth/severe birth defect
•Congenital rubella syndrome- 1st
trimester infection
•CNS – microcephaly, cortical /basal
ganglia calcification
•Others
•Cataracts, glaucoma,
chorioretinitis
•Cardiac anomalies
•Deafness
•CNS Imaging – similar to other
viral infections, nonspecific
13. Axial NECT in congenital Rubella infection showing extensive
calcifications in basal ganglia, cerebral white matter and cortex
14. Congenital Herpes simplex
• HSV -2
• Findings 2-4 wks after birth
• Diffuse brain involvement
• CT
-focal/diffuse white matter lucency,
relative hyperdense cortex
- hemorrhagic infarcts/ thrombosis
-diffuse atrophy & multicystic
encephalomalacia later
MRI
- diffuse white matter edema, hemorrhagic
infarcts/thrombosis, parenchymal or
meningeal enhancement after contrast
administration
15. Zika virus infections
• Pathology :Fetal germinal matrix
Imaging CT :
1.cerebral calcification(GM-WM is most common site)
2. cerebral, cerebellar and brainstem volume loss
3. ventriculomegaly and microcephaly
4. polymicrogyria, lissencephaly and pachygyria
5. occipital and periventricular cysts
MRI( SWI ) : depict parenchymal Calcifications
Cortical migration defect ventriculomegaly
16.
17. Perinatal (congenital) HIV
•Perinatal transmission –m.c. route
•Only 1/3rd of infected mother can transmit.
•CNS symptoms – HIV encephalitis
•NECT –Diffuse cerebral atrophy (nearly 90% cases)
- Basal ganglia calcifications (1/3rd cases)
- Hemorrhage (thrombocytopenia)
18.
19. Meningitis
Infective or inflamatory process of dura mater,
leptomeninges (pia and arachnoid) and CSF within
subarachnoid space.
Pachymeningitis (dura + arachnoid)
Meningoencephalitis (+ underlying parenchymal
inflamation)
Types of meningitis:
• Acute pyogenic meningitis
• Acute lymphocytic meningitis(Viral)
• Chronic meningitis (any infectious agent including fungi and parasites)
20. Role of CT in meningitis
• to identify contraindications of a lumbar puncture
• to identify complications .
• CT scans may reveal the cause of meningeal infection.
• Otorhinologic structures and congenital and posttraumatic
calvarial defects can also be evaluated
• CT cisternography may depict CSF leaks, which may be the
source of infection in cases of recurrent meningitis
21. Nonenhanced CT scan findings
• may be normal (>50% of patients)
• effacement of basilar & convexity cisterns by inflammatory
exudates and brain swelling
• may demonstrate mild ventricular dilatation and effacement of
sulci
• cerebral edema and focal low-attenuating lesions.
• Sequelae from meningitis like periventricular and meningeal
calcifications
22. Contrast-enhanced CT scans
•Meningeal & ependymal enhancement
•Help in detecting complications of meningitis, such as
• subdural empyema
• Venous thrombosis, infarction
• Cerebritis/abscess
• Ventriculitis.
23.
24.
25. •Role of neuroimaging studies :
typically used to monitor complications.
•Complications
•Hydrocephalus
•Ventriculitis/ependimitis
•Subdural effusion/empyema
•Cerebritis/abscess
•Infarcts (vasculitis/vasospasm)
•Dural sinus thrombosis/venous
infarcts
•Cerebral edema
26.
27. Acute lymphocytic meningitis (viral)
• Benign & self limited
• Viral in origin
• Enterovirus (50-80%) – echovirus,
coxakie viurs and non paralytic polio
virus, mumps, EBV, arbovirus
• Imaging usually normal unless
coexisting encephalitis
• Brain swelling and meningeal
enhancement in some cases.
28. Chronic meningitis
• Tubercular(most common), coccidiodomycosis,
cryptococcus
• Hematogenous spread from the pulmonary tuberculosis is
the common mechanism.
• Predominantly basilar exudates
• Sequelae- Pachymeningitis, ischemia/infarcts, atrophy,
calcifications.
32. Cerebritis/cerebral abscess
• Focal cerebritis( focal usually pyogenic infection without
capsule or pus formation) is the earliest stage of pyogenic
brain infection from which the abscess evolves.
Sources-
1. Direct extension from adjacent structures (in about half
of cases)
2. Haematogenous
3. Penetrating trauma
33. Early cerebritis(3-5days)-
• Initial phase of abscess.
• Focal infection
• Uncapsulated mass of congested vessels with
perivascular PMNs infiltration and edema develops.
Late cerebritis(7-10 days)-
• central necrotic core forms ,surrounded by outer ill-
defined ring of inflammatory cells, macrophage,
granulation tissue and fibroblast.
Pathological stages
34. Early Capsule(10-14 days)-central core of liquified necrotic debris
surrounded by well delineated capsule composed of collagen and
reticulin, initially thin and incomplete ,more collagen deposited,
becomes thicker. Gliosis begins at periphery.
Late Capsule(>14 days)-capsule is complete & has 3 layers-
1.inner inflammatory layer of macrophage and granulation tissue
2.middle collagenous layer
3.Outer gliotic layer
• Late capsule stage lasts for several weeks to months.
• Cavity gradually shrinks and abscess heals.
35. • Early cerebritis- normal or may show poorly marginated subcortical
hypodense area with ill-defined enhancement in CT.
MRI- poorly marginated subcortical hyperintense area in T2WI.
- ill-defined contrast enhanced area within hypointense edema onT1
Images.
37. • Early capsule- Thin(<5mm),well-delineated, distinct capsule that enhances
strongly, uniformly and continuosly, surrounding edema present, thinner
medial/ventricular margin. Rim is iso-hyperintense on T1 & iso-
hypointense on T2WI
38.
39. • Late capsule- size of abscess gradually shrinks, edema diminishes. Rim
enhancement persists for months. Hypointense rim in T2 images
late capsule stage abscess: (Left) Axial T2WI MR shows a hyperintense mass with a
hypointense rim at the gray-white junction , surrounding vasogenic edema.
(Right) Axial T1 C+ MR shows a thick wall of enhancement
40. Ring enhancing lesions D/D
D/D Features
Metastasis GW junction; multiple
Abscess Restriction of diffusion in DWI d/t high viscocity of central necrosis
Smooth hypointense rim in T2WI
Glioma (GBM) Thick irregular wall
Elevated perfusion inhigh grade glioma in perfusion MRI
Infarct (subacute) Usually gyral enh;
Costusion (subacute to chronic)
Demyelination (MS) the ring is incomplete and open towards the cortex
Radiation necrosis Low perfusion in perfusion MRI
Others Toxoplasmosis; Primary CNS lymphoma in AIDS
41. Encephalitis
• Diffuse, nonfocal brain parenchymal inflammatory disease
due to spectrum of agents
• Viral
• Non viral
• Auto immune encephalitides – ADEM(post
infective/vaccination)
42. Herpes simplex encephalitis
• Most common viral encephalitis
• HSV 1usually activation of latent infection in trigeminal
ganglion
• Fulminant, necrotising, hemorrhagic; considerable mass effect.
• Mortality upto 55%.
• Predilection for limbic system- inferomedial temporal lobe,
orbital surface of frontal lobe , insular cortex, cingulate gyrus
• Sequential bilaterality – highly suggestive
43. •Imaging
• CT – often normal in early
disease.
• In adults, CT classically reveals
hypodensity in the temporal
lobes with or without frontal
lobe involvement, usually with
mass effect. Hemorrhage
appear slightly later.
• CECT – ill defined patchy or
gyriform enhancement
• In chronic stage – large low
density areas with associated
local atrophy in the affected
region.
44.
45. Togavirus (Japanese Encephalitis)
Deep-seated structures characteristically involved:
subcortical white matter (top arrow), thalami (middle
arrow), and substantia nigra (bottom arrow)
46. Acute disseminated encephalomyelitis (ADEM)
• Monophasic demyelinating disorder that occur after vaccination or
viral illness.
• Fulminant course, results in encephalopathy and focal neurological
deficits, and usually resolve without long term sequelae.
• MRI – multiple large irregular T2 hyperintense lesions in subcortical
white matter, cerebellum and brain stem.
48. CNS tuberculosis
• CT: non caseating granuloma –hyper/isodese with homogenous
enhancement, caseating granulomas enhance peripherally , target sign
49. • MRI:
non caseating granuloma- iso/hypointense on T1 & hyperintense on T2
with homogenous C++
Caseating solid granuloma- hypointense on T1 & strikingly hypointense
on T2
Granulomas with central liquefaction- hypo on T1 & on T2 hyper with
peripheral hypointense rim
54. Neurocysticercosis
• Larval form of T. solium – cysticercus cellulosae
• Most common CNS parasite
• location
• Subarachnoid space
• Brain parenchyma- corticomedullary junction
• Intraventricular in 20-50% cases
• Dying larva incite host inflamatory reaction & calcifies later
55. Pathological stages and Imaging
• Vesicular: Cyst with “dot” (scolex), no edema, no enhancement.
(MRI - cyst is isointense to CSF and scolex is isointense to white
matter)
• Colloidal vesicular: Ring enhancement, edema striking Cyst
contents hyperintense on T1- and T2-weighted images
(proteinaceous fluid), cyst wall is thick and hypointense)
• Granular nodular: Faint rim enhancement, edema decreased
• Nodular calcified: CT Ca++, MR “black dots”
59. Echinococcosis
•Larval stage- hydatid cyst
•Cerebral hydatid- seen in only 2% cases
•Imaging
• Single thin walled spherical CSF density cyst
• Large cystic lesion lying subcortically in middle cerebral
territory of parietal area (can reach large size often over 6 cm
in diameter).
• No edema or enhancement or adjacent calcification.
• Enhancement and perilesional edema are seen only if the cyst is
superinfected.
60.
61.
62. Prion infection
Creutzfeldt–Jakob disease (CJD)
• The typical MRI appearance of CJD
is cortical ribboning, which
describes ribbonlike FLAIR
hyperintensity and restricted
diffusion of the cerebral cortex. The
basal ganglia and thalami are also
involved. There is often sparing of
the motor cortex.
• The pulvinar sign describes bright
DWI and FLAIR signal within the
pulvinar nucleus of the thalamus.
The hockey stick sign describes
bright DWI and FLAIR signal within
the dorsomedial thalamus and
pulvinar.
63.
64.
65. COVID-19
• COVID-19–associated acute necrotizing hemorrhagic encephalopathy, a rare
encephalopathy that has been associated with other viral infections but has
yet to be demonstrated as a result of COVID-19 infection.
• Acute necrotizing encephalopathy (ANE) is a rare complication of influenza
and other viral infections and has been related to intracranial cytokine storms,
which result in blood-brainbarrier breakdown, but without direct viral invasion
or parainfectious demyelination. Severe COVID-19 might have a cytokine
storm syndrome
• Cortical signal abnormalities, particular attention was paid to presence of
subtle hemorrhagic changes or leptomeningeal enhancement. Additionally,
acute cerebrovascular disease, venous thrombosis, and chronic parenchymal
changes were also seen in very few case.
During I trimester: Neuronal migration disorder
During II trimester :
Hydrancephaly
Microcephaly
porencephaly
1)Congenital CMV is shown with periventricular parenchymal calcifications , damaged white matter, dysplastic cortex .2)Large ventricle ,shallow sylvian fissure, periventricular Ca++
NECT scan shows diffuse hypodensity in cerebral white matter and dense appearing cortex (Congenital Herpes encephalitis)
Neuroimaging studies are typically used to monitor complications such as hydrocephalus, subdural effusion, empyema (see Images 1-5, 8-10), and infarction (see Images 8-9, 11) to exclude parenchymal abscess (see Images 4, 7, 12) and ventriculitis. Neuroimaging is indicated in patients who havevidence of head trauma, sinus or mastoid infection (see Images 1-4), skull fracture, and congenital anomalies.
Most common complication associated with meningitis – due to blokage of CSF flow and resorption pathway by the debris mainly at the level of arachnoid villi.
Leptomeningeal – ependymal fibrosis – irreversible communicating obstructive hydrocephalus.
Abscess in a patient with bacterial meningitis. This contrast-enhanced computed tomography scan shows a ring-enhancing, hypoattenuating mass (abscess) with peripheral edema and mass effect
Ventriculitis in a patient with bacterial meningitis. This contrast-enhanced computed tomography scan shows ependymal enhancement.
Extensive popcorn like calcification in basal cisterns(arrows)
Early cerebritis- normal or may show poorly marginated subcortical hypodense area with ill-defined enhancement in CT.
MRI- poorly marginated subcortical hyperintense area in T2WI.
- ill-defined contrast enhanced area within hypointense edema onT1 Images.
Late cerebritis- central low density with irregular enhancing rim, surrounding vasogenic edema
Early capsule- Thin(<5mm),well-delineated,distinct capsule that enhances strongly,uniformly and continuosly, surrounding edema present, thinner medial/ventricular margin. Rim is iso-hyperintense on T1 & iso-hypointense on T2WI
Late capsule- size of abscess gradually shrinks, edema diminishes. Rim enhancement persists for months. Hypointense rim in T2 images.
MAGIC DR (metastasis, abscess, glioma, infarct, contusion,demyelination, and radiation
initial lesions are unilateral but are followed by less severe contralateral disease.
either unilaterally or bilaterally, Changes may be minimal in the first 2-3 days despite severe neurological impairment and should be carefully sought.
MR – more sensitive to white matter changes; shows the lesion to be more extensive than they appear on the CT; can identify at earlier stage as gyral edema, temporal lobe hyperintensity in T2WI, +/- enhancement
hemorrhage – increased signal intensity on T1WI and usually implies extensive necrosis.
MRI also shows extensive periventricular signal changes not apparent on CT.
Hematogenous dissemination usually from pulmonary infection
Meningitis- most common manifestation
Tuberculoma
Parenchymal lesions
Caseating granuloma
Usually solitary, multiple in 1/3
Cortical, subcortical, basal ganglia lesions. Cerebellum in children
Fecooral transmission
(**Common to have lesions in different stages)
In rare cases there may be more than one cyst lying deeply adjacent to ventricles.
MRI – no particular advantage over CT.