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Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Pre-Course Activities
1 topic, 3 min.
Lesson
Introduction to Stroke Imaging
4 topics, 17 min.
Lesson
Noncontrast CT
5 topics, 14 min.
Lesson
CTA Neck
10 topics, 33 min.
Vascular Imaging in Stroke - CTA vs MRA
2 m.Carotid and Vertebral Vasculopathies Overview & Examples of Atherosclerotic Disease
3 m.Case - Atheromatous Disease with Severe ICA Stenosis
4 m.Carotid & Vertebral Artery Dissection Overview & Examples
3 m.Case - Embolic Stroke with ICA Dissection
5 m.Collagen Vascular Diseases Overview - Examples of FMD, Carotid Web
2 m.Case - Fibromuscular Dysplasia (FMD)
5 m.Case - Ehlers Danlos
7 m.Inflammatory Conditions with Stroke Symptoms - Examples of Takayasu's, TIPIC
4 m.Case - Takayasu’s Arteritis
4 m.Lesson
CTA Head
9 topics, 37 min.
CTA Head in Acute Stroke - Source Images, MIPS, Collaterals
4 m.Case - MCA Stem Embolus with Good Collaterals
5 m.Case - MCA Stem Embolus with Poor Collaterals
4 m.Case - Basilar Tip Thrombus
6 m.Circle of Willis Stenoses: Differential Diagnoses
2 m.Case - Moya Moya disease
6 m.Case - Reversible Cerebral Vasoconstrictive Syndrome (RCVS)
5 m.Case - Primary Angiitis of the CNS (PACNS)
7 m.Infectious Causes of Multifocal Circle of Willis Stenosis
2 m.Lesson
CT Perfusion
3 topics, 15 min.
Lesson
MRI (DWI, FLAIR, SWI) of Acute Stroke
3 topics, 14 min.
Lesson
MRA of Head and Neck
6 topics, 18 min.
Lesson
Multifocal Strokes With No Visualized Vascular Abnormality
6 topics, 26 min.
Lesson
Brain Ischemia, Hypoxia, & Death
6 topics, 16 min.
Lesson
Stroke Mimics & Other Causes of Restricted Diffusion
7 topics, 18 min.
Stroke Mimics - Other Causes of Restricted Diffusion
2 m.Case - Seizure (Stroke Mimic)
4 m.Case - MELAS (Stroke Mimic)
3 m.Case - Hypoglycemia (Stroke Mimic)
3 m.Case - Herpes Virus Encephalitis (Stroke Mimic)
4 m.Case - Osmotic Demyelination Syndrome (Stroke Mimic)
3 m.Case - Brain Metastases (Stroke Mimic)
4 m.Lesson
MR Perfusion
8 topics, 17 min.
MR Perfusion - Data, Maps and Uses
4 m.Case - MR Perfusion Target Mismatch (Good Collaterals)
2 m.Case - MR Perfusion Target Mismatch (Poor Collaterals)
3 m.Case - Ischemia Detected Only on MR Perfusion (Case 1)
2 m.Case - Ischemia Detected Only on MR Perfusion (Case 2)
3 m.Arterial Spin Labelling Perfusion - Usage Examples
3 m.Case - ASL Matched Defect
2 m.Case - ASL Showing Tissue at Risk
2 m.Lesson
Subacute Stroke & Differentials
5 topics, 13 min.
0:00
Now that we've imaged the head,
0:02
we're going to talk about imaging the vessels.
0:04
CTA is the best way to image the vessels.
0:07
It allows for most rapid evaluation of
0:09
the vessels from the arch to the vertex.
0:12
It allows you to determine hairline residual
0:15
lumen versus occlusion, intravascular
0:18
thrombus, and whether or not stents are
0:21
reoccluded compared to MRA and ultrasound.
0:24
And in the head, which we're going to get
0:26
to a little bit later, it allows detection
0:27
of large vessel occlusions with greater
0:30
than 95% sensitivity and specificity.
0:33
and allows rapid triage of
0:34
patients for thrombolysis,
0:36
and assessment of collateral circulation.
0:40
So, these are some key carotid artery findings.
0:43
You can see on the left here a patient with
0:45
atheromatous disease and a critical stenosis.
0:48
The vessel is so tight that
0:50
the distal lumen is collapsed.
0:52
On MRA, you might not even
0:54
be able to see this, but this
0:56
correlates nicely with a subsequent angio.
0:59
So, critical stenosis with collapsed vessel.
1:02
The next set of images is a
1:04
patient with intraluminal thrombus.
1:06
You can see on the sagittal, this filling defect
1:10
and on the axial image, you can see
1:12
this clot in the middle of the vessel,
1:15
an MRA that can be confused with flow
1:17
artifact and can be difficult to diagnose.
1:19
That's intraluminal thrombus.
1:21
And then, this is an example of a stent.
1:23
You can see there's a stent here.
1:25
And then on this MRA, you see signal dropout.
1:28
You don't know if it's a critical stenosis.
1:30
You really don't know what's going
1:32
on there, but when you do a CTA,
1:34
you can see that the vessel's patent.
1:35
There's some narrowing from internal
1:38
hyperplasia, but the stent's widely patent.
1:41
So for critical stenosis, intraluminal
1:45
thrombus and stents, CTA is really
1:48
the best way to evaluate the vessels.
Vascular Imaging in Stroke - CTA vs MRA
HIDEInteractive Transcript
0:00
Now that we've imaged the head,
0:02
we're going to talk about imaging the vessels.
0:04
CTA is the best way to image the vessels.
0:07
It allows for most rapid evaluation of
0:09
the vessels from the arch to the vertex.
0:12
It allows you to determine hairline residual
0:15
lumen versus occlusion, intravascular
0:18
thrombus, and whether or not stents are
0:21
reoccluded compared to MRA and ultrasound.
0:24
And in the head, which we're going to get
0:26
to a little bit later, it allows detection
0:27
of large vessel occlusions with greater
0:30
than 95% sensitivity and specificity.
0:33
and allows rapid triage of
0:34
patients for thrombolysis,
0:36
and assessment of collateral circulation.
0:40
So, these are some key carotid artery findings.
0:43
You can see on the left here a patient with
0:45
atheromatous disease and a critical stenosis.
0:48
The vessel is so tight that
0:50
the distal lumen is collapsed.
0:52
On MRA, you might not even
0:54
be able to see this, but this
0:56
correlates nicely with a subsequent angio.
0:59
So, critical stenosis with collapsed vessel.
1:02
The next set of images is a
1:04
patient with intraluminal thrombus.
1:06
You can see on the sagittal, this filling defect
1:10
and on the axial image, you can see
1:12
this clot in the middle of the vessel,
1:15
an MRA that can be confused with flow
1:17
artifact and can be difficult to diagnose.
1:19
That's intraluminal thrombus.
1:21
And then, this is an example of a stent.
1:23
You can see there's a stent here.
1:25
And then on this MRA, you see signal dropout.
1:28
You don't know if it's a critical stenosis.
1:30
You really don't know what's going
1:32
on there, but when you do a CTA,
1:34
you can see that the vessel's patent.
1:35
There's some narrowing from internal
1:38
hyperplasia, but the stent's widely patent.
1:41
So for critical stenosis, intraluminal
1:45
thrombus and stents, CTA is really
1:48
the best way to evaluate the vessels.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Vascular
Neuroradiology
Neuro
MRA
Head and Neck
CTA
Brain
Angiography
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