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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
Today, we're going to talk a little bit about
0:02
vessel wall imaging.
0:03
You need a very high resolution black blood technique.
0:06
Typically, you want to use a 3 T magnet
0:08
and a 3D acquisition with isotropic voxels
0:11
with a very small 0.4 to 0.7 millimeter range.
0:16
It's done with a turbo fast spin echo technique
0:19
with variable low refocusing flip angles,
0:21
and you might know it better as SPACE or
0:23
CUBE or VISTA or some other vendor name.
0:27
There are a few main things we want to talk about
0:29
with intracranial steno-occlusive disease.
0:32
Atherosclerotic disease has eccentric wall enhancement,
0:35
vasculitis tends to have concentric wall enhancement.
0:39
RCVS has some wall thickening
0:41
but little to no enhancement.
0:43
Moya moya disease has no enhancement.
0:45
And dissection,
0:46
you can see the intimal flap on T2 weighted
0:50
high resolution images and intramural hematoma
0:53
on T1 weighted images.
0:55
Typically, though,
0:56
what you're doing is T1 weighted images,
0:57
pre and post-contrast,
0:59
to differentiate the various entities.
1:02
If you do vessel wall imaging with RCVS,
1:06
you will see a little thickened wall,
1:08
but you don't really see enhancement
1:11
because it's vasospasm and not really inflammation.
1:14
You can see the narrowings of the vessels here
1:16
and the PCAs and the MCAs,
1:19
and the proximal ACAs.
1:20
And then, primary CNS vasculitis is an inflammatory process
1:24
and what you tend to get is circumferential,
1:27
smooth circumferential thickening
1:29
like you can see in the distal ICA
1:31
and proximal MCA here,
1:33
and you can see narrowing of the vessel on this MRA.
1:36
This was from a nice paper by Dr. Obusez
1:39
and AJNR in 2014.
MRI Vessel Wall Imaging Overview
HIDEInteractive Transcript
0:00
Today, we're going to talk a little bit about
0:02
vessel wall imaging.
0:03
You need a very high resolution black blood technique.
0:06
Typically, you want to use a 3 T magnet
0:08
and a 3D acquisition with isotropic voxels
0:11
with a very small 0.4 to 0.7 millimeter range.
0:16
It's done with a turbo fast spin echo technique
0:19
with variable low refocusing flip angles,
0:21
and you might know it better as SPACE or
0:23
CUBE or VISTA or some other vendor name.
0:27
There are a few main things we want to talk about
0:29
with intracranial steno-occlusive disease.
0:32
Atherosclerotic disease has eccentric wall enhancement,
0:35
vasculitis tends to have concentric wall enhancement.
0:39
RCVS has some wall thickening
0:41
but little to no enhancement.
0:43
Moya moya disease has no enhancement.
0:45
And dissection,
0:46
you can see the intimal flap on T2 weighted
0:50
high resolution images and intramural hematoma
0:53
on T1 weighted images.
0:55
Typically, though,
0:56
what you're doing is T1 weighted images,
0:57
pre and post-contrast,
0:59
to differentiate the various entities.
1:02
If you do vessel wall imaging with RCVS,
1:06
you will see a little thickened wall,
1:08
but you don't really see enhancement
1:11
because it's vasospasm and not really inflammation.
1:14
You can see the narrowings of the vessels here
1:16
and the PCAs and the MCAs,
1:19
and the proximal ACAs.
1:20
And then, primary CNS vasculitis is an inflammatory process
1:24
and what you tend to get is circumferential,
1:27
smooth circumferential thickening
1:29
like you can see in the distal ICA
1:31
and proximal MCA here,
1:33
and you can see narrowing of the vessel on this MRA.
1:36
This was from a nice paper by Dr. Obusez
1:39
and AJNR in 2014.
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
Brain
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