Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
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
So, these are images of an 84-year-old female
0:03
who has left sided weakness.
0:05
In non-contrast CT,
0:07
essentially shows nothing acute,
0:10
basically has some white matter disease.
0:12
So, that was the non-contrast CT.
0:15
And then the CTA,
0:17
basically, the intracranial circulation looks normal.
0:20
The whole right MCA, the left MCA,
0:23
the ACAs looked normal.
0:25
She did have some clot in her
0:27
right ICA in the neck,
0:29
but it looks like there's good cross-filling,
0:31
so you really don't know how old the chronic
0:34
occlusion is and how good is the cross-filling.
0:37
She had weakness,
0:38
but the CTA of the neck looks pretty good.
0:40
So, we got diffusion and perfusion.
0:45
You can see here's the diffusion,
0:47
and nothing was really seen
0:48
on the diffusion images.
0:50
Some slight hyperintensity here,
0:52
but we did not have low signal in the ADC maps.
0:55
But you can see on the transit time maps
0:59
that there's the whole hemisphere.
1:01
Right MCA and ACA territories
1:04
looks like there's extensively
1:06
prolonged transit time.
1:08
So you're worried that there's tissue at risk,
1:10
but the DWI looks pretty normal.
1:12
So, this is very helpful for fusion.
1:14
She was given maximum therapy,
1:17
medication in hypertension.
1:19
So, she was imaged several days later.
1:23
And you can see that the whole border zone
1:28
that there's a large border zone infarction,
1:31
some temporal lobe lesions,
1:32
and then these lesions in the corona radiata
1:34
going up into the subcortical white matter
1:36
in some cortex.
1:37
So, again,
1:38
the perfusion was really the only sequence
1:42
that could identify tissue at risk.
1:45
It was not obvious from the non-contrast CT,
1:47
the CTA,
1:48
or the initial diffusion weighted images.
Case - Ischemia Detected Only on MR Perfusion (Case 1)
HIDEInteractive Transcript
0:00
So, these are images of an 84-year-old female
0:03
who has left sided weakness.
0:05
In non-contrast CT,
0:07
essentially shows nothing acute,
0:10
basically has some white matter disease.
0:12
So, that was the non-contrast CT.
0:15
And then the CTA,
0:17
basically, the intracranial circulation looks normal.
0:20
The whole right MCA, the left MCA,
0:23
the ACAs looked normal.
0:25
She did have some clot in her
0:27
right ICA in the neck,
0:29
but it looks like there's good cross-filling,
0:31
so you really don't know how old the chronic
0:34
occlusion is and how good is the cross-filling.
0:37
She had weakness,
0:38
but the CTA of the neck looks pretty good.
0:40
So, we got diffusion and perfusion.
0:45
You can see here's the diffusion,
0:47
and nothing was really seen
0:48
on the diffusion images.
0:50
Some slight hyperintensity here,
0:52
but we did not have low signal in the ADC maps.
0:55
But you can see on the transit time maps
0:59
that there's the whole hemisphere.
1:01
Right MCA and ACA territories
1:04
looks like there's extensively
1:06
prolonged transit time.
1:08
So you're worried that there's tissue at risk,
1:10
but the DWI looks pretty normal.
1:12
So, this is very helpful for fusion.
1:14
She was given maximum therapy,
1:17
medication in hypertension.
1:19
So, she was imaged several days later.
1:23
And you can see that the whole border zone
1:28
that there's a large border zone infarction,
1:31
some temporal lobe lesions,
1:32
and then these lesions in the corona radiata
1:34
going up into the subcortical white matter
1:36
in some cortex.
1:37
So, again,
1:38
the perfusion was really the only sequence
1:42
that could identify tissue at risk.
1:45
It was not obvious from the non-contrast CT,
1:47
the CTA,
1:48
or the initial diffusion weighted images.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Perfusion
Neuroradiology
Neuro
MRP
MRI
Head and Neck
CTA
CT
Brain
© 2025 Medality. All Rights Reserved.