This document discusses definitions and classifications of subcortical lesions seen on MRI brain imaging. It defines perivascular spaces, lacunes, subcortical white matter changes, and microbleeds. For each type of lesion, it provides histopathological definitions as well as MRI-based definitions in terms of appearance and severity scales. It also discusses the vascular supply of the brain and implications for the pathogenesis of these subcortical lesions.
This document defines several types of brain lesions that can be seen on MRI scans:
1. Perivascular spaces seen as punctiform dilatations in white matter and basal ganglia.
2. Lacunes appear as small hyperintense lesions on T2WI and hypointense on T1WI, up to 10mm in size.
3. Subcortical white matter changes range from focal lesions to diffuse involvement, graded from 0-3 in severity.
4. Microbleeds appear as homogeneous, round signal losses up to 5mm on gradient echo imaging.
It also provides definitions for assessing the severity and location of intracranial vessel stenosis seen on MRI and methods for measuring
This document discusses degenerative and white matter diseases of the central nervous system. It focuses on white matter disease, describing different types including demyelinating and dysmyelinating diseases. For demyelinating diseases, it provides detailed information about multiple sclerosis (MS), including its incidence, clinical presentation, radiographic features on CT and MRI, variants like tumefactive and Marburg MS, and McDonald criteria for diagnosing MS. It also briefly discusses other causes of white matter disease like post-viral white matter disease, toxic leukoencephalopathy, vascular white matter disease, and infectious white matter diseases.
The document discusses patterns of brain enhancement seen on MRI or CT after contrast administration. It describes 6 common patterns: 1) Periventricular enhancement which can be seen in conditions like lymphoma, infections, or multiple sclerosis. 2) Gyriform enhancement seen in herpes encephalitis, infarcts, or PRES. 3) Nodular subcortical enhancement typically seen in metastatic disease. 4) Ring enhancement commonly from abscesses, metastases, or high grade tumors. 5) Pachymeningeal enhancement of the dura. 6) Leptomeningeal enhancement of the pia-arachnoid membranes. Normal structures that enhance include the choroid plexus, pituitary gland, pineal
Diagnostic Imaging of Salivary, Parathyroid and Thyroid GlandsMohamed M.A. Zaitoun
This document provides an overview of salivary gland, parathyroid gland, and thyroid gland diseases. It discusses several common salivary gland conditions including sialolithiasis, sialosis, sialoadenitis, Sjogren's disease, and cystic lesions. For each condition, it describes the incidence, etiology, location, and radiographic features as seen on imaging like CT, MRI, ultrasound, and sialography. It provides examples of images showing the characteristic findings of each disease. In summary, the document is a radiologist's guide to recognizing and differentiating various head and neck gland diseases based on their imaging appearance.
This document discusses bone marrow diseases, including malignant infiltration, secondary marrow hyperplasia, and lysosomal storage diseases. Specific diseases covered include multiple myeloma, leukemia, sickle cell anemia, thalassemia, Gaucher's disease, and Niemann-Pick disease. For each, the document discusses incidence, radiographic manifestations, and differential diagnosis. Radiographic findings include bone marrow hyperplasia, osteopenia, bone infarcts, vertebral compression fractures, and organomegaly of the spleen and liver. The goal is to understand the disease processes and radiologic presentations to aid in successful patient management.
This document provides an overview of cerebellopontine angle masses, including their incidence, location, and radiographic features. It discusses the most common masses such as vestibular schwannoma (acoustic neuroma), CPA meningioma, and epidermoid cyst. For each type of mass, it describes their typical appearance on CT and MRI scans, including signal characteristics and enhancement patterns. It also provides differential diagnoses to help distinguish between different pathologies that can present in the CPA region. The goal is to help readers learn as much as possible about CPA masses to aid in successful diagnosis and management.
This document summarizes several congenital pulmonary abnormalities:
1. Bronchopulmonary foregut malformations include congenital cystic adenomatoid malformation (CCAM), pulmonary sequestration, and foregut duplication cysts. CCAM appears as multiple cysts on imaging and can cause respiratory distress. Pulmonary sequestration involves aberrant lung tissue with a systemic blood supply.
2. Other abnormalities discussed include congenital lobar emphysema, pulmonary underdevelopment, Scimitar syndrome, bronchial atresia, congenital diaphragmatic hernia, and Kartagener’s syndrome. Each condition has specific radiographic features and clinical presentations.
This document summarizes an MRI case study of a patient with multiple sclerosis. The MRI images show:
- Multiple oval or rounded lesions that are hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images, with some lesions perpendicular to the ventricles characteristic of MS.
- Some lesions show ring enhancement on post-contrast T1 images, indicating dissemination in time with both active and chronic components.
- Based on the widespread lesions distributed in both space and time seen on MRI, the diagnosis is chronic multiple sclerosis in exacerbation.
This document defines several types of brain lesions that can be seen on MRI scans:
1. Perivascular spaces seen as punctiform dilatations in white matter and basal ganglia.
2. Lacunes appear as small hyperintense lesions on T2WI and hypointense on T1WI, up to 10mm in size.
3. Subcortical white matter changes range from focal lesions to diffuse involvement, graded from 0-3 in severity.
4. Microbleeds appear as homogeneous, round signal losses up to 5mm on gradient echo imaging.
It also provides definitions for assessing the severity and location of intracranial vessel stenosis seen on MRI and methods for measuring
This document discusses degenerative and white matter diseases of the central nervous system. It focuses on white matter disease, describing different types including demyelinating and dysmyelinating diseases. For demyelinating diseases, it provides detailed information about multiple sclerosis (MS), including its incidence, clinical presentation, radiographic features on CT and MRI, variants like tumefactive and Marburg MS, and McDonald criteria for diagnosing MS. It also briefly discusses other causes of white matter disease like post-viral white matter disease, toxic leukoencephalopathy, vascular white matter disease, and infectious white matter diseases.
The document discusses patterns of brain enhancement seen on MRI or CT after contrast administration. It describes 6 common patterns: 1) Periventricular enhancement which can be seen in conditions like lymphoma, infections, or multiple sclerosis. 2) Gyriform enhancement seen in herpes encephalitis, infarcts, or PRES. 3) Nodular subcortical enhancement typically seen in metastatic disease. 4) Ring enhancement commonly from abscesses, metastases, or high grade tumors. 5) Pachymeningeal enhancement of the dura. 6) Leptomeningeal enhancement of the pia-arachnoid membranes. Normal structures that enhance include the choroid plexus, pituitary gland, pineal
Diagnostic Imaging of Salivary, Parathyroid and Thyroid GlandsMohamed M.A. Zaitoun
This document provides an overview of salivary gland, parathyroid gland, and thyroid gland diseases. It discusses several common salivary gland conditions including sialolithiasis, sialosis, sialoadenitis, Sjogren's disease, and cystic lesions. For each condition, it describes the incidence, etiology, location, and radiographic features as seen on imaging like CT, MRI, ultrasound, and sialography. It provides examples of images showing the characteristic findings of each disease. In summary, the document is a radiologist's guide to recognizing and differentiating various head and neck gland diseases based on their imaging appearance.
This document discusses bone marrow diseases, including malignant infiltration, secondary marrow hyperplasia, and lysosomal storage diseases. Specific diseases covered include multiple myeloma, leukemia, sickle cell anemia, thalassemia, Gaucher's disease, and Niemann-Pick disease. For each, the document discusses incidence, radiographic manifestations, and differential diagnosis. Radiographic findings include bone marrow hyperplasia, osteopenia, bone infarcts, vertebral compression fractures, and organomegaly of the spleen and liver. The goal is to understand the disease processes and radiologic presentations to aid in successful patient management.
This document provides an overview of cerebellopontine angle masses, including their incidence, location, and radiographic features. It discusses the most common masses such as vestibular schwannoma (acoustic neuroma), CPA meningioma, and epidermoid cyst. For each type of mass, it describes their typical appearance on CT and MRI scans, including signal characteristics and enhancement patterns. It also provides differential diagnoses to help distinguish between different pathologies that can present in the CPA region. The goal is to help readers learn as much as possible about CPA masses to aid in successful diagnosis and management.
This document summarizes several congenital pulmonary abnormalities:
1. Bronchopulmonary foregut malformations include congenital cystic adenomatoid malformation (CCAM), pulmonary sequestration, and foregut duplication cysts. CCAM appears as multiple cysts on imaging and can cause respiratory distress. Pulmonary sequestration involves aberrant lung tissue with a systemic blood supply.
2. Other abnormalities discussed include congenital lobar emphysema, pulmonary underdevelopment, Scimitar syndrome, bronchial atresia, congenital diaphragmatic hernia, and Kartagener’s syndrome. Each condition has specific radiographic features and clinical presentations.
This document summarizes an MRI case study of a patient with multiple sclerosis. The MRI images show:
- Multiple oval or rounded lesions that are hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images, with some lesions perpendicular to the ventricles characteristic of MS.
- Some lesions show ring enhancement on post-contrast T1 images, indicating dissemination in time with both active and chronic components.
- Based on the widespread lesions distributed in both space and time seen on MRI, the diagnosis is chronic multiple sclerosis in exacerbation.
This document discusses nephrocalcinosis and kidney stones. It begins by defining nephrocalcinosis and distinguishing it from kidney stones. It then discusses the incidence, radiographic features and locations where kidney stones commonly become lodged in the ureter. The document also describes dystrophic and metastatic nephrocalcinosis, their causes, and how they appear on ultrasound. Cortical and medullary nephrocalcinosis are specifically examined in terms of their etiology and ultrasound characteristics.
1. Spinal arachnoid cysts are CSF-filled sacs contained by arachnoid mater that are most commonly located in the thoracic region. On MRI they have CSF-like signal intensity on T1 and T2 sequences and do not enhance with contrast.
2. Spinal epidermoid cysts are rare, cystic tumors lined by squamous epithelium that are often associated with spinal malformations. On MRI they appear hyperintense on FLAIR and restrict diffusion, appearing bright on DWI sequences.
3. The document discusses the radiographic features and characteristics of various intradural and extradural spinal masses. It provides details on MRI appearance and distinguishing features to aid
This document discusses osteonecrosis and osteochondrosis. It defines osteonecrosis as bone death due to interruption of blood supply and describes its common causes and radiographic features including MRI appearance. Specific types discussed include Kienbock's disease, Preiser's disease, and Legg-Calve-Perthes disease. Osteochondrosis is defined as abnormal bone and cartilage development, with subtypes including Scheuermann's disease, Osgood-Schlatter disease, and Blount's disease caused by repetitive stress without necrosis, as well as osteonecrosis conditions. Radiographic features of each condition are provided.
Diagnostic Imaging of Congenital Central Nervous System DiseasesMohamed M.A. Zaitoun
This document provides an overview of congenital central nervous system diseases, including:
1. Neural tube closure defects such as anencephaly, Chiari malformations, and cephaloceles. Anencephaly is the most common neural tube defect and presents as absent brain tissue above the orbits.
2. Disorders of diverticulation and cleavage involving abnormalities such as dysgenesis of the corpus callosum. Dysgenesis can be complete or partial absence and is commonly associated with other CNS anomalies.
3. Posterior fossa malformations including Chiari malformations. Chiari I involves tonsillar herniation while Chiari II presents with herniation of brainstem and cerebell
This document describes a technique for biopsying sub-centimeter pulmonary nodules using CT-guided core needle biopsy. The technique involves inducing perilesional hemorrhage near mobile nodules, which helps fix their position and allows them to be pierced by the biopsy needle. Five nodules between 7.5-9.2mm were biopsied using this technique. Mild hemorrhage occurred near all nodules without complications. The technique obtained adequate diagnostic samples from all nodules, confirming metastases. Inducing hemorrhage effectively fixes small, slippery nodules for biopsy.
This document discusses the anatomy and common mass lesions of the orbit. It begins with an overview of orbital anatomy, describing the structures within the intraconal and extraconal spaces. Common orbital mass lesions are then reviewed, including those arising within the globe like retinoblastoma and melanoma, as well as lesions in the intraconal, extraconal, and orbital wall spaces. Specific details are provided on the incidence, clinical and radiographic features, and differential diagnosis of retinoblastoma and melanoma. Other globally arising lesions like choroidal detachment are also mentioned.
This document discusses various toxic and metabolic diseases that can cause abnormalities in the brain. It provides details on liver disease, hypoglycemia, hypoxic ischemic encephalopathy, methanol poisoning, and carbon monoxide poisoning. For each condition, the mechanism and characteristic radiographic findings on techniques such as CT, MRI, T1, T2, FLAIR, and diffusion weighted imaging are described. Bilateral abnormalities are often seen in the basal ganglia, thalamus, and cerebral cortex on imaging for these toxic and metabolic diseases.
1. The document discusses various spinal infections and inflammatory conditions, including spondylodiskitis, spinal tuberculosis (Pott's disease), epidural abscess, and others.
2. For spondylodiskitis, the etiology can be pyogenic, tuberculosis, or fungal. MRI is the most sensitive imaging method, showing low T1 and high T2 signal in the infected disc space and bone marrow edema.
3. Spinal tuberculosis causes vertebral body destruction and gibbus deformity. It spreads underneath the longitudinal ligaments. Imaging shows bone destruction, kyphosis, and paraspinal abscesses without severe pain.
This document summarizes various pathologies that can affect the eye and orbit. It discusses congenital anomalies, infections and inflammations, tumors, trauma, and miscellaneous conditions. For each condition, it provides a brief description and highlights relevant imaging findings on modalities such as CT, MRI, and plain films. Key features that help characterize many lesions include enhancement pattern, presence of calcification, and signal characteristics on different MRI sequences.
Presentation1, new mri techniques in the diagnosis and monitoring of multiple...Abdellah Nazeer
This document discusses new MRI techniques for diagnosing and monitoring multiple sclerosis (MS). It recommends protocols for baseline and follow-up brain and spinal cord MRIs, including mandatory and optional sequences. Advanced techniques like double inversion recovery, diffusion tensor imaging, and MR spectroscopy are highlighted for improving detection of gray matter lesions and diffuse white matter damage compared to conventional MRI. The document concludes that while conventional MRI is important for MS, advanced techniques provide higher sensitivity and specificity for both lesions and normal-appearing brain tissue, furthering understanding of MS pathophysiology.
1) The document discusses intrinsic and extrinsic pineal region masses, focusing on benign cysts, germ cell tumors, and teratomas.
2) Benign cysts are common incidental findings that appear fluid-like on MRI but may enhance along the rim. Germinomas are the most common pineal germ cell tumor, appearing solid with homogeneous enhancement.
3) Teratomas contain fat, calcium, and mixed signal components due to varying tissue types, and demonstrate little enhancement post-contrast. Differential diagnosis and radiologic features of common pineal region lesions are provided.
Presentation2, radiological imaging of neck schwannoma.Abdellah Nazeer
A 32-year-old female presented with a left facial nerve schwannoma. Imaging showed a bilobed hyperintense mass in the left parotid and mastoid regions on T2-weighted imaging, connected by an interconnecting stalk along the vertical segment of the facial nerve. There was restricted diffusion seen within the peripheral rim of the tissue. Schwannomas are benign nerve sheath tumors that commonly occur in the head and neck region, arising from the cranial nerves. They appear as well-defined masses that are iso- to hyperintense on T1- and T2-weighted MRI relative to muscle. Characteristic features include identification of the nerve of origin and restricted diffusion.
Presentation1, radiological imaging of trigeminal schwanoma.Abdellah Nazeer
The document discusses trigeminal schwannomas, which are slow-growing tumors composed of schwann cells that occur along the trigeminal nerve. It provides details on the epidemiology, clinical presentation, and radiographic features of trigeminal schwannomas. Specifically, it notes that trigeminal schwannomas most commonly present in the third to fourth decades of life and typically manifest as trigeminal nerve dysfunction. Radiographically, they often have a dumbbell appearance on MRI when extending between compartments, and demonstrate enhancement following contrast administration. The document includes several images showing examples of trigeminal schwannomas along different segments of the nerve.
This document provides an overview of the primary, secondary, and delayed effects of cerebral trauma. It discusses various types of fractures, extra-axial hemorrhages including epidural hematomas, subdural hematomas, subarachnoid hemorrhage, and intraventricular hemorrhage. It also covers intra-axial injuries such as cortical contusions, intraparenchymal hematomas, and diffuse axonal injury. For each type of injury, the document discusses etiology, location, radiographic features, and grading where applicable. It includes various CT and MRI images to illustrate examples of different traumatic brain injuries.
Presentation1, radiological application of diffusion weighted imges in neuror...Abdellah Nazeer
1) The document discusses the use of diffusion-weighted MRI in detecting areas of restricted diffusion in various neurological conditions and diseases. It provides examples of several conditions that appear bright on DWI imaging such as acute ischemic stroke, traumatic brain injuries, encephalitis, spinal cord ischemia, and arterial dissections.
2) Restricted diffusion occurs when there is a reduction in the normal random movement of water molecules within tissues, appearing as hyperintense signals on DWI images. This can be caused by cellular swelling, reduced extracellular space, or fragmentation of cellular components.
3) The timing of imaging after an event such as stroke or trauma influences the appearance of lesions on DWI and ADC maps, with restricted diffusion detectable
This document discusses three common pediatric hip lesions:
1) Congenital hip dislocation, which occurs in neonates and infants and is diagnosed using ultrasound or x-rays to evaluate femoral head coverage and bone morphology.
2) Legg-Calve-Perthes disease, which causes osteonecrosis of the femoral head in school-aged children and is staged using x-rays or MRI to assess bone changes over time.
3) Slipped capital femoral epiphysis, which occurs in adolescents and is diagnosed on x-rays by a displaced femoral neck that no longer intersects the epiphysis.
Role of head and neck imaging preview in patient with trigeminal neuralgia /c...Indian dental academy
This document discusses head and neck imaging for patients with trigeminal neuralgia. It provides details on the course of the trigeminal nerve and branches. Common causes of trigeminal neuralgia include neurovascular compression, tumors, multiple sclerosis, and vascular abnormalities. Imaging plays an important role in the diagnosis and evaluation of trigeminal neuralgia. MRI is often the preferred imaging method as it can directly depict the trigeminal nerve and show compression from neighboring vessels. 3D CISS MRI provides high resolution images of both arteries and veins. Imaging is used to identify compressive lesions and rule out other causes of facial pain such as tumors.
Presentation1, radiological imaging of cavernous sinus lesions.Abdellah Nazeer
This document discusses radiological imaging of lesions in the cavernous sinus. It begins with an overview of cavernous sinus anatomy and venous drainage. Common tumors and lesions that can involve the cavernous sinus are then described, including pituitary adenomas, meningiomas, schwannomas, metastases, and vascular lesions such as aneurysms and carotid-cavernous fistulas. For each type of lesion, key imaging features on CT and MRI are provided.
Presentation1.pptx radio;ogical imaging of benign and malignant soft tissue t...Abdellah Nazeer
This document summarizes several benign soft tissue tumors seen on radiological imaging. It describes infantile hemangioma, lymphangioma, angiomatosis, neurofibroma, myofibroma/myofibromatosis, and neurothecoma. For each tumor, it provides definitions, epidemiology including common sites of involvement, clinical findings, and imaging characteristics such as appearance on CT, MRI, and ultrasound. The document contains various images demonstrating the radiological presentation of these soft tissue tumors.
This study used micro-computed tomography (micro-CT) to characterize the 3D structure of intravascular and extravascular microvessels in a rabbit model of chronic total occlusion over time. Two distinct types of microvessels were observed - circumferentially oriented extravascular microvessels along the vessel wall, and longitudinally oriented intravascular microvessels within the occluded lumen. Extravascular microvessels were most prominent at 2 weeks and gradually reduced over time, while intravascular microvessel formation peaked at 6 weeks and remained present but finer at later time points. Differences in the temporal and spatial patterns of microvessel formation provide new insights into chronic total occlusion maturation.
Plaque rupture relationship to plaque composition in coronary arteries. A 320...Apollo Hospitals
Coronary thrombosis leading to myocardial ischemia is now recognized as a diverse process arising from plaque rupture, erosion, or calcified nodules. These vulnerable plaques may not always cause significant stenosis of the artery, and therefore be missed on an invasive catheter angiogram (ICA). The advent of multidetector computed tomography (MDCT) imaging of the walls of the coronary artery has opened a unique window to these vulnerable plaques. Differentiation of calcified plaques from soft plaques presents no challenge on CT. Further characterization of the plaque into a ruptured plaque is possible by demonstration of discontinuity of the plaque surface and contrast pooling within the plaque substance.
This document discusses nephrocalcinosis and kidney stones. It begins by defining nephrocalcinosis and distinguishing it from kidney stones. It then discusses the incidence, radiographic features and locations where kidney stones commonly become lodged in the ureter. The document also describes dystrophic and metastatic nephrocalcinosis, their causes, and how they appear on ultrasound. Cortical and medullary nephrocalcinosis are specifically examined in terms of their etiology and ultrasound characteristics.
1. Spinal arachnoid cysts are CSF-filled sacs contained by arachnoid mater that are most commonly located in the thoracic region. On MRI they have CSF-like signal intensity on T1 and T2 sequences and do not enhance with contrast.
2. Spinal epidermoid cysts are rare, cystic tumors lined by squamous epithelium that are often associated with spinal malformations. On MRI they appear hyperintense on FLAIR and restrict diffusion, appearing bright on DWI sequences.
3. The document discusses the radiographic features and characteristics of various intradural and extradural spinal masses. It provides details on MRI appearance and distinguishing features to aid
This document discusses osteonecrosis and osteochondrosis. It defines osteonecrosis as bone death due to interruption of blood supply and describes its common causes and radiographic features including MRI appearance. Specific types discussed include Kienbock's disease, Preiser's disease, and Legg-Calve-Perthes disease. Osteochondrosis is defined as abnormal bone and cartilage development, with subtypes including Scheuermann's disease, Osgood-Schlatter disease, and Blount's disease caused by repetitive stress without necrosis, as well as osteonecrosis conditions. Radiographic features of each condition are provided.
Diagnostic Imaging of Congenital Central Nervous System DiseasesMohamed M.A. Zaitoun
This document provides an overview of congenital central nervous system diseases, including:
1. Neural tube closure defects such as anencephaly, Chiari malformations, and cephaloceles. Anencephaly is the most common neural tube defect and presents as absent brain tissue above the orbits.
2. Disorders of diverticulation and cleavage involving abnormalities such as dysgenesis of the corpus callosum. Dysgenesis can be complete or partial absence and is commonly associated with other CNS anomalies.
3. Posterior fossa malformations including Chiari malformations. Chiari I involves tonsillar herniation while Chiari II presents with herniation of brainstem and cerebell
This document describes a technique for biopsying sub-centimeter pulmonary nodules using CT-guided core needle biopsy. The technique involves inducing perilesional hemorrhage near mobile nodules, which helps fix their position and allows them to be pierced by the biopsy needle. Five nodules between 7.5-9.2mm were biopsied using this technique. Mild hemorrhage occurred near all nodules without complications. The technique obtained adequate diagnostic samples from all nodules, confirming metastases. Inducing hemorrhage effectively fixes small, slippery nodules for biopsy.
This document discusses the anatomy and common mass lesions of the orbit. It begins with an overview of orbital anatomy, describing the structures within the intraconal and extraconal spaces. Common orbital mass lesions are then reviewed, including those arising within the globe like retinoblastoma and melanoma, as well as lesions in the intraconal, extraconal, and orbital wall spaces. Specific details are provided on the incidence, clinical and radiographic features, and differential diagnosis of retinoblastoma and melanoma. Other globally arising lesions like choroidal detachment are also mentioned.
This document discusses various toxic and metabolic diseases that can cause abnormalities in the brain. It provides details on liver disease, hypoglycemia, hypoxic ischemic encephalopathy, methanol poisoning, and carbon monoxide poisoning. For each condition, the mechanism and characteristic radiographic findings on techniques such as CT, MRI, T1, T2, FLAIR, and diffusion weighted imaging are described. Bilateral abnormalities are often seen in the basal ganglia, thalamus, and cerebral cortex on imaging for these toxic and metabolic diseases.
1. The document discusses various spinal infections and inflammatory conditions, including spondylodiskitis, spinal tuberculosis (Pott's disease), epidural abscess, and others.
2. For spondylodiskitis, the etiology can be pyogenic, tuberculosis, or fungal. MRI is the most sensitive imaging method, showing low T1 and high T2 signal in the infected disc space and bone marrow edema.
3. Spinal tuberculosis causes vertebral body destruction and gibbus deformity. It spreads underneath the longitudinal ligaments. Imaging shows bone destruction, kyphosis, and paraspinal abscesses without severe pain.
This document summarizes various pathologies that can affect the eye and orbit. It discusses congenital anomalies, infections and inflammations, tumors, trauma, and miscellaneous conditions. For each condition, it provides a brief description and highlights relevant imaging findings on modalities such as CT, MRI, and plain films. Key features that help characterize many lesions include enhancement pattern, presence of calcification, and signal characteristics on different MRI sequences.
Presentation1, new mri techniques in the diagnosis and monitoring of multiple...Abdellah Nazeer
This document discusses new MRI techniques for diagnosing and monitoring multiple sclerosis (MS). It recommends protocols for baseline and follow-up brain and spinal cord MRIs, including mandatory and optional sequences. Advanced techniques like double inversion recovery, diffusion tensor imaging, and MR spectroscopy are highlighted for improving detection of gray matter lesions and diffuse white matter damage compared to conventional MRI. The document concludes that while conventional MRI is important for MS, advanced techniques provide higher sensitivity and specificity for both lesions and normal-appearing brain tissue, furthering understanding of MS pathophysiology.
1) The document discusses intrinsic and extrinsic pineal region masses, focusing on benign cysts, germ cell tumors, and teratomas.
2) Benign cysts are common incidental findings that appear fluid-like on MRI but may enhance along the rim. Germinomas are the most common pineal germ cell tumor, appearing solid with homogeneous enhancement.
3) Teratomas contain fat, calcium, and mixed signal components due to varying tissue types, and demonstrate little enhancement post-contrast. Differential diagnosis and radiologic features of common pineal region lesions are provided.
Presentation2, radiological imaging of neck schwannoma.Abdellah Nazeer
A 32-year-old female presented with a left facial nerve schwannoma. Imaging showed a bilobed hyperintense mass in the left parotid and mastoid regions on T2-weighted imaging, connected by an interconnecting stalk along the vertical segment of the facial nerve. There was restricted diffusion seen within the peripheral rim of the tissue. Schwannomas are benign nerve sheath tumors that commonly occur in the head and neck region, arising from the cranial nerves. They appear as well-defined masses that are iso- to hyperintense on T1- and T2-weighted MRI relative to muscle. Characteristic features include identification of the nerve of origin and restricted diffusion.
Presentation1, radiological imaging of trigeminal schwanoma.Abdellah Nazeer
The document discusses trigeminal schwannomas, which are slow-growing tumors composed of schwann cells that occur along the trigeminal nerve. It provides details on the epidemiology, clinical presentation, and radiographic features of trigeminal schwannomas. Specifically, it notes that trigeminal schwannomas most commonly present in the third to fourth decades of life and typically manifest as trigeminal nerve dysfunction. Radiographically, they often have a dumbbell appearance on MRI when extending between compartments, and demonstrate enhancement following contrast administration. The document includes several images showing examples of trigeminal schwannomas along different segments of the nerve.
This document provides an overview of the primary, secondary, and delayed effects of cerebral trauma. It discusses various types of fractures, extra-axial hemorrhages including epidural hematomas, subdural hematomas, subarachnoid hemorrhage, and intraventricular hemorrhage. It also covers intra-axial injuries such as cortical contusions, intraparenchymal hematomas, and diffuse axonal injury. For each type of injury, the document discusses etiology, location, radiographic features, and grading where applicable. It includes various CT and MRI images to illustrate examples of different traumatic brain injuries.
Presentation1, radiological application of diffusion weighted imges in neuror...Abdellah Nazeer
1) The document discusses the use of diffusion-weighted MRI in detecting areas of restricted diffusion in various neurological conditions and diseases. It provides examples of several conditions that appear bright on DWI imaging such as acute ischemic stroke, traumatic brain injuries, encephalitis, spinal cord ischemia, and arterial dissections.
2) Restricted diffusion occurs when there is a reduction in the normal random movement of water molecules within tissues, appearing as hyperintense signals on DWI images. This can be caused by cellular swelling, reduced extracellular space, or fragmentation of cellular components.
3) The timing of imaging after an event such as stroke or trauma influences the appearance of lesions on DWI and ADC maps, with restricted diffusion detectable
This document discusses three common pediatric hip lesions:
1) Congenital hip dislocation, which occurs in neonates and infants and is diagnosed using ultrasound or x-rays to evaluate femoral head coverage and bone morphology.
2) Legg-Calve-Perthes disease, which causes osteonecrosis of the femoral head in school-aged children and is staged using x-rays or MRI to assess bone changes over time.
3) Slipped capital femoral epiphysis, which occurs in adolescents and is diagnosed on x-rays by a displaced femoral neck that no longer intersects the epiphysis.
Role of head and neck imaging preview in patient with trigeminal neuralgia /c...Indian dental academy
This document discusses head and neck imaging for patients with trigeminal neuralgia. It provides details on the course of the trigeminal nerve and branches. Common causes of trigeminal neuralgia include neurovascular compression, tumors, multiple sclerosis, and vascular abnormalities. Imaging plays an important role in the diagnosis and evaluation of trigeminal neuralgia. MRI is often the preferred imaging method as it can directly depict the trigeminal nerve and show compression from neighboring vessels. 3D CISS MRI provides high resolution images of both arteries and veins. Imaging is used to identify compressive lesions and rule out other causes of facial pain such as tumors.
Presentation1, radiological imaging of cavernous sinus lesions.Abdellah Nazeer
This document discusses radiological imaging of lesions in the cavernous sinus. It begins with an overview of cavernous sinus anatomy and venous drainage. Common tumors and lesions that can involve the cavernous sinus are then described, including pituitary adenomas, meningiomas, schwannomas, metastases, and vascular lesions such as aneurysms and carotid-cavernous fistulas. For each type of lesion, key imaging features on CT and MRI are provided.
Presentation1.pptx radio;ogical imaging of benign and malignant soft tissue t...Abdellah Nazeer
This document summarizes several benign soft tissue tumors seen on radiological imaging. It describes infantile hemangioma, lymphangioma, angiomatosis, neurofibroma, myofibroma/myofibromatosis, and neurothecoma. For each tumor, it provides definitions, epidemiology including common sites of involvement, clinical findings, and imaging characteristics such as appearance on CT, MRI, and ultrasound. The document contains various images demonstrating the radiological presentation of these soft tissue tumors.
This study used micro-computed tomography (micro-CT) to characterize the 3D structure of intravascular and extravascular microvessels in a rabbit model of chronic total occlusion over time. Two distinct types of microvessels were observed - circumferentially oriented extravascular microvessels along the vessel wall, and longitudinally oriented intravascular microvessels within the occluded lumen. Extravascular microvessels were most prominent at 2 weeks and gradually reduced over time, while intravascular microvessel formation peaked at 6 weeks and remained present but finer at later time points. Differences in the temporal and spatial patterns of microvessel formation provide new insights into chronic total occlusion maturation.
Plaque rupture relationship to plaque composition in coronary arteries. A 320...Apollo Hospitals
Coronary thrombosis leading to myocardial ischemia is now recognized as a diverse process arising from plaque rupture, erosion, or calcified nodules. These vulnerable plaques may not always cause significant stenosis of the artery, and therefore be missed on an invasive catheter angiogram (ICA). The advent of multidetector computed tomography (MDCT) imaging of the walls of the coronary artery has opened a unique window to these vulnerable plaques. Differentiation of calcified plaques from soft plaques presents no challenge on CT. Further characterization of the plaque into a ruptured plaque is possible by demonstration of discontinuity of the plaque surface and contrast pooling within the plaque substance.
Tips, Pearls and Pitfalls of Spinal Cord MRIWafik Bahnasy
- Many neurological disorders simultaneously or consecutively affect the brain and spinal cord, however most neurologist find their comfort zone in attending the diagnosis via the brain access.
- This concept resulted in lagging of spinal cord imaging researches compared to brain ones and consecutive underestimation of the opportunity of an important tool sometimes essential to reach a definite diagnosis.
Issues in radiological pathology: Radiological pathology of watershed infarct...Professor Yasser Metwally
The document discusses border zone or watershed infarcts, which occur at the junction between two main arterial territories and constitute approximately 10% of all brain infarcts. There are two types - external (cortical) and internal (subcortical). External infarcts are often embolic in nature while internal infarcts are mainly caused by hemodynamic compromise. Advanced imaging can help identify areas of low perfusion and distinguish the two types. The document then examines the classification, imaging appearance, causal mechanisms, and clinical course of both external and internal border zone infarcts in more detail.
This document provides information about various cardiovascular pathology cases for medical students. It includes questions and descriptions of thrombus, organizing thrombus, atherosclerosis, lung and spleen infarction, mesenteric artery occlusion, aortic dissection, myocardial infarction, and jars containing specimens of lung infarction, bowel infarction, early and advanced atherosclerosis, aortic dissection, left ventricular hypertrophy, and old myocardial infarction. Students are asked to identify features, causes, and complications represented in the images and specimens.
Imaging in Neurovascular conflicts [Neurovascular compression syndrome ]Nija Panchal
- Neurovascular compression syndrome (NVCS) refers to nerve compression by aberrant or tortuous blood vessels, which can cause cranial nerve dysfunction including trigeminal neuralgia.
- Trigeminal neuralgia is characterized by abrupt, unilateral facial pain and is most often caused by neurovascular compression of the trigeminal nerve at the root entry/exit zone from the brainstem.
- MRI with techniques like CISS and MRA-TOF are effective in evaluating neurovascular relationships and compressions, aiding surgical planning for microvascular decompression to treat refractory trigeminal neuralgia.
CEREBRAL INFARCTS
Pathophysiology
Significantly diminished blood supply to all parts(global ischemia) or selected areas(regional or focal ischemia) of the brain
Focal ischemia- cerebral infarction
Global ischemia-hypoxic ischemic encephalopathy(HIE), hypotensive cerebral infarction
Infarct vs pneumbra
In the central core of the infarct, the severity of hypoperfusion results in irreversible cellular damage
Around this core, there is a region of decreased flow in which either:
The critical flow threshold for cell death has not reached
Or the duration of ischemia has been insufficient to cause irreversible damage.
Current therapies attempt to rescue these ‘at risk’ cells
Goal of imaging
Exclude hemorrhage
Identify the presence of an underlying structural lesion such as tumour , vascular malformation, subdural hematoma that can mimic stroke
Identify stenosis or occlusion of major extra- and intracranial arteries
Differentiate between irreversibly affected brain tissue and reversibly impaired tissue (dead tissue versus tissue at risk)
Imaging modalities
CT
MRI
Diffusion weighted imaging
MRA
MRS
CT angiography
CT perfusion imaging
Perfusion-weighted MR Imaging
Trans cranial doppler
Cerebral angiography
Classification
Hyper acute infarct (<12 hours)
Acute infarct (12 to 48 hours)
Subacute infarct (2 to 14 days)
Chronic infarct (>2 weeks)
Old infarct (> 8 to 10 weeks)
CT-Hyperacute infarct
Normal in 50 – 60%
Hyperdense MCA sign-acute intraluminal thrombus
Obscuration of lentiform nulei
Dot sign-occluded MCA branch in sylvian fissure
Insular ribbon sign –grey white interface loss along the lateral insula
Hyperdense MCA sign
Obscuration of lentiform nuclei
Insular ribbon sign
Insular ribbon sign
MRI –Hyperacute infarct
Absence of normal flow void with intra vascular arterial enhancement
Anatomic changes in T1WI
Sulcal effacement,
Gyral edema,
Loss of grey white interface
Sulcal effacement
CT- Acute infarct
Low density basal ganglia
Sulcal effacement
Wedge shaphed parenchymal hypo density area that involves both grey and white matter
Increasing mass effect
Hemorrhagic transformation may occur -15 to 45% ( basal ganglia and cortex common site) in 24 to 48 hours
Sulcal effacement
MRI –Acute infarct
T2WI-hyperintensity in affected area
Meningeal enhancement adjacent to infarct(12 to 24 hours)
Early parenchymal enhancement
Hemorrhagic transformation becomes evident
MRI –Acute infarct
MRI –Acute infarct
CT – sub acute infarct
NECT
Wedge-shaped area of decreased attenuation involving gray/white matter in typical vascular distribution
Mass effect initially increases, then begins to
diminish by 7-10 days
HT of initially ischemic infarction occurs in 15-20% of MCA occlusions, usually by 48-72 hrs
CECT
Enhancement patterns typically patchy or gyral
May appear as early as 2-3 days after ictus, persisting up to 8-10 weeks
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This study used medical imaging and computational modeling to analyze blood flow patterns in a patient with an aortic dissection. Computational fluid dynamics (CFD) models of the patient's aorta were created using CT and MRI imaging data. Simulations were performed to: 1) Compare flow patterns in the dissected aorta to a healthy aorta model; 2) Estimate the increased workload on the heart from the dissection; and 3) Analyze the impact of secondary tears in the dissection flap on flow. The results provide insights into complex hemodynamics in dissections that may help predict patient outcomes.
131 the evolution of coronary atherosclerosisSHAPE Society
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Important radiological classification of fracture and AVNDr pradeep Kumar
This is Important radio-logical classification of fracture and AVN, I made this from various references like radiopaedia and radiology website , It will help for radiology resident, radiologist and even orthopedics resident. Thanks.
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Wilhelm Roentgen discovered X-rays in 1895 in Germany. He observed that X-rays could pass through human tissue and cast shadows of bones on photographic plates. In recognition of this groundbreaking discovery, Roentgen received the first Nobel Prize in Physics in 1901. X-rays provide valuable medical imaging by allowing visualization of internal structures in the body.
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These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
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7. 1. Perivascular spaces (etatcrible) 1) Histopathologic definition (ref. 1) : the dilatation of perivascular spaces around cerebral arterioles in the brain of elderly patients (Virchow-Robin space) 2) MRI definition (ref. 1) : the punctiform dilatations of the perivascular spaces often seen by brain MRI in the white matter and in the basal ganglia
8. 1. Perivascular spaces (etatcrible) 2) MRI definition : the punctiform dilatations of the perivascular spaces often seen by brain MRI in the white matter and in the basal ganglia : On T2WI – high intensity, same as the intensity of CSF : On FLAIR – dark (low), same as the intensity of CSF : On T1WI – dark (low), same as the intensity of CSF http://www.radiologyassistant.nl/en/4556dea65db62
11. 2. Lacunes 1) Histopathologic definition : a small, cystic cavity of the brain substance that usually results from an ischemic infarction in the territory of a penetrating arteriole (ref. 1)
12. 2. Lacunes 2) Vascular pathology of lacunes (ref. 13)
13. 2. Lacunes 3) Perforating arteries (1) Anterior perforating arteries (2) Posterior perforating arteries (3) Arterial supply of the brainstem
15. (1) Anterior perforating arteries A. Perforating branches arising from ACA and the recurrent artery of Heubner
16. (1) Anterior perforating arteries B. Perforating branches arising from MCA a. Perforating branches arising from MCA
17. (1) Anterior perforating arteries B. Perforating branches arising from MCA b. Percentage of perforating arteries arising from MCA trunk and its branches
18. (1) Anterior perforating arteries B. Perforating branches arising from MCA c. Origin of perforating arteries arising from MCA trunk and its branches
19. (1) Anterior perforating arteries B. Perforating branches arising from MCA d. Number of perforating arteries arising from different distances from the origin of MCA
20. (1) Anterior perforating arteries B. Perforating branches arising from MCA e. Branching characteristics of 508 perforating arteries arising from common stems of MCA
26. 2. Lacunes 4) Pathogenic implications of microcirculation (1) Perforating arteries 1) Stenosis or complete occlusion by atherosclerosis 2) Stenosis or occlusion of ostium of a branch point 3) Atherosclerotic narrowing of a parent artery 4) Proximal thrombus or embolus in atherosclerotic artery (2) Cortical branches
27. 4) Pathogenic implications of microcirculation (1) Perforating arteries A. Stenosis or complete occlusion by atherosclerosis
28. 4) Pathogenic implications of microcirculation (1) Perforating arteries B. Stenosis or occlusion of ostium of a branch point
29. 4) Pathogenic implications of microcirculation (1) Perforating arteries C. Atherosclerotic narrowing of a parent artery
30. 4) Pathogenic implications of microcirculation (1) Perforating arteries D. Proximal thrombus or embolus in atherosclerotic artery
32. 2. Lacunes 5) MRI definition (ref. 2) : small hyperintense lesions on T2WI (ref. 2) : corresponding distinctive low intensity area on T1WI : Maximum size of lacune (ref. 4) - with a diameter of 5-10 mm : On CT (ref. 4) - areas of more or less complete focal tissue destruction - clearly defined borders with marked central hypodensity on CT : On MRI (ref. 4) - low intensity on T1WI, proton-density and FLAIR scans - high intensity on T2WI -> isointense to CSF
34. 2. Lacunes 1) Histopathologic definition : a small, cystic cavity of the brain substance that usually results from an ischemic infarction in the territory of a penetrating arteriole (ref. 1) : defined as cavitatedmicroinfarcts or encephalomalacic lesions, 2 mm or smaller in greatest dimension, not identifiable with certainty on gross inspection of the brain or non-cavitatedmicroinfarcts, focal gliotic areas without a cystic cavity (ref. 3)
38. 3. Subcortical white matter change 1) Definition of Binswanger’s disease (1894) : pronounced atrophy of the white matter, either confined to one or more gyri of the brain or in several sections of the hemisphere : in the most severe cases the entire white matter of a cerebral lobe appears to have completely wasted away : a severe atheromatosis of the arteries of the brain is always present in these cases : extensive atrophic degeneration or fatty degeneration of the small arterial and venous vessels : partial thickening of the inner and middle vascular membranes : the lumen is correspondingly narrowed
39. 3. Subcortical white matter change 2) Definition of leukoaraiosis (Hachinski et al., 1987) : loss of density of the periventricular white matter observed by CT of the brain : the white matter changes commonly observed in the elderly by MRI of the brain
40. 3. Subcortical white matter change 3) Mechanisms hypothesized to be involved in the pathogenesis of white matter change (ref. 14)
41. 3. Subcortical white matter change 4) Small vessel changes related to white matter changes (ref. 14)
42. 3. Subcortical white matter change 5) Evolution of white matter lesions (ref. 16)
43. 3. Subcortical white matter change 6) Definition of ‘Periventricular’ and ‘Deep white matter’ change (ref.5) (1) Periventricular - Start directly at the ventricular border
44.
45. 3. Subcortical white matter change 6) Definition of ‘Periventricular’ and ‘Deep white matter’ change (ref.5) (3) Selective deep white matter lesion - usually characterized by a rim of normal-appearing tissue which separates them from the periventricular region
46. 3. Subcortical white matter change 6) Definition of ‘Periventricular’ and ‘Deep white matter’ change (ref.5) (4) Basal ganglia hypodensities on CT or hyperintensity on MRI (M/82)
47. 3. Subcortical white matter change 6) Definition of ‘Periventricular’ and ‘Deep white matter’ change (ref.24)
48. 3. Subcortical white matter change 6) Definition of ‘Periventricular’ and ‘Deep white matter’ change – (1) (ref.5) Periventricularhyperintensity 0 = absence 1 = “caps” or pencil-thin lining 2 = smooth “halo” 3 = irregular PVH extending into the deep white matter (2) Deep white matter hyperintense signal 0 = absence 1 = punctuate foci 2 = beginning confluence of foci 3 = large confluent areas
49. 3. Subcortical white matter change 7) Definition of ‘Periventricular’ and ‘Deep white matter’ –(3) (ref. 6) (1) White matter lesions 0 = no lesions (including symmetrical, well-defined caps or bands) 1 = Focal lesions 2 = Beginning confluence of lesions 3 = Diffuse involvement of the entire region, with or without involvement of U fibers (2) Basal ganglia lesions 0 = No lesions 1 = 1 focal lesion (≥ 5 mm) 2 = > 1 focal lesion 3 = Confluent lesions
50. 3. Subcortical white matter change 7) Definition of ‘Periventricular’ and ‘Deep white matter’ –(3) (ref. 6) 1. Score of 1
51. 3. Subcortical white matter change 7) Definition of ‘Periventricular’ and ‘Deep white matter’ –(3) (ref. 6) 2. Score of 2
52. 3. Subcortical white matter change 7) Definition of ‘Periventricular’ and ‘Deep white matter’ –(3) (ref. 6) 3. Score of 3
54. 3. Subcortical white matter change (1) White matter lesions 2 = Beginning confluence of lesions
55. 3. Subcortical white matter change (1) White matter lesions 3 = Diffuse involvement of the entire region, with or without involvement of U fibers (M/75)
56. 3. Subcortical white matter change (1) White matter lesions 3 = Diffuse involvement of the entire region, with or without involvement of U fibers (M/60)
61. 4. Microbleeds 1) Histopathologic and MRI definition : paramagnetic material which produces local susceptibility gradients and thereby causes a faster decay of transverse magnetization on gradient-echo acquisition (ref. 18) : remnants of even minor blood leakage through damaged vessel walls
63. 4. Microbleeds 2) Severity of amyloidangiopathy (ref. 27) Figure 1. Grading of CAA severity in single brain samples (ref. 27) 0: No cerebral vessels showed immunopositivity for beta amyloid 1+: Amyloid is restricted to a rim around smooth muscle fibers in the media of occasional normal vessels 2+: The media is thicker than normal and circumferentially replaced by amyloid in a few vessels 3+: Widespread medial thickening and circumferential amyloid deposition with a small halo of immunoreactivity in the surrounding parenchyma : A focus of wall leakage as evidenced by fresh hemorrhage or hemosiderin-laden macrophages, or occlusion, or recanalization
64. 4. Microbleeds 3) MRI definition of microbleed (ref. 2, 19, 20, 21) (1) Homogeneous round signal loss lesion with a diameter of up to 5 mm (or <10 mm) on gradient echo image Distinct from a. Vascular flow voids on subarachnoid space b. Leptomeningealhemasiderosis c. Non-hemorrhagic subcortical mineralization
73. 4. Microbleeds 4) Degree of severity of microbleeds (ref. 2) (1) Absent (2) Mild – total number of MBs, 1-5 (3) Moderate – total number of MBs, 6-15 (4) Severe – total number of MBs, >15
74. 4. Microbleeds 5) The locations of the microbleeds and lacunes (ref. 2) (1) Cortico-subcortical (2) Basal ganglia (3) Thalamus (4) Brain stem (5) Cerebellum
78. Regional location of stenosis (ref. 9) : Schematic representation of 11 arterial segments studied by transcranial Doppler and duplex ultrasound MCA – 1 and 2 ACA – 3 and 4 PCA – 5 and 6 Siphon ICA – 7 and 8 Extracranial ICA - 9 and 10 Vertebrobasilar artery – 11
79.
80. Measuement of vessel stenosis (ref. 10) 2. Criteria for normal proximal artery (3) Third choice A. If the entire intracranial artery was diseased -> the most distal, parallel, non-tortous normal segment of the feeding artery B. If the entire middle cerebral artery was diseased -> measured at the most distal, parallel segement of the supraaclinoid carotid artery C. If the entire intracranial vertebral artery was diseased -> measured at the most distal, parallel, non-tortous normal segment of the extracranial vertebral artery
81. Measuement of vessel stenosis (ref. 10) 2. Criteria for normal proximal artery 2) For the ICA (1) First choice : The precavernous, cavernous, and postcavernous stenoses of ICA -> measured at the widest, non-tortous, normal portion of the petrous carotid artery that had parallel margins
82. Measuement of vessel stenosis (ref. 10) 2. Criteria for normal proximal artery 2) For the ICA (2) Second choice - If the entire petrous carotid was diseased -> the most distal, parallel part of the extracranial internal carotid artery was substituted - If tandem intracranial lesions were present -> percent stenosis of both sites was measured and the more severe stenosis was selected - When a “gap sign” was present -- the lumen of the vessel could not be visualized at the site of severe stenosis -- could not be measured -- defined as 99% luminal stenosis
83. Measuement of vessel stenosis (ref. 10) 1. Equation for measuring intracranial arterial stenosis
84. Measuement of vessel stenosis 2. Equation for measuring extracranial arterial stenosis 1) Severity of intracranial stenosis (ref. 11, 12) (1) Mild - <30% (2) Moderate – 30% - 69% (3) Severe – 70% - 99% - in case of segmental signal void -> the stenosis was graded as severe (>70%) (4) Occluded
85. Measuement of vessel stenosis 2. Equation for measuring extracranial arterial stenosis 2) Measurement of the carotid artery stenosis (ref. 12) (1) NASCET : (1-md/C)x100% (2) ECST : (1-md/B)x100% (3) CC : (1-md/A)x100%