Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
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
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Who We Serve
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.
Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
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
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Who We Serve
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
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
© 2024 Medality. All Rights Reserved.