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.
0:01
These are images of a patient who came in with
0:04
some mental status changes and
0:07
intermittent speech changes.
0:09
And you can see this lesion characterized by
0:12
partially restricted diffusion.
0:14
DWI, bright.
0:15
ADC, dark.
0:16
Part of it's sort of isointense on ADC images.
0:20
When you're comparing it with the FLAIR
0:21
abnormality and the sort of wedge
0:23
shape defect on FLAIR,
0:26
that's a little bit bigger than the DWI and ADC
0:28
because, as you can see,
0:29
some parts of this are already
0:30
pseudo normalized in ADC.
0:32
So, it kind of looks like a subacute infarct.
0:35
But let's keep inspecting more
0:37
because it could be some funny tumor.
0:39
And you can see these little
0:40
areas of petechial hemorrhage,
0:42
which would be hemorrhagic infarction 1,
0:44
according to ECA.
0:46
In the area of the restrictive diffusion,
0:49
we also gave contrast,
0:51
and you can see on this contrast
0:53
enhanced scan in that region,
0:55
there's gyroform enhancement throughout that region,
1:00
and we can follow that all the way up.
1:02
We can also look at that in another plane.
1:05
And again,
1:05
you can see the enhancements gyroform,
1:07
which is very classic of both arterial
1:10
and venous infarction.
1:11
This is in an MCA distribution.
1:13
So, we're kind of thinking that this is
1:15
a subacute infarction with swelling,
1:16
gyroform enhancement and petechial hemorrhage.
1:19
And then, we'll take a look at the MRA.
1:22
And you can see on the MRA,
1:24
there's stenosis near the MCA bifurcation.
1:27
There's relatively poor flow related
1:29
enhancement in the MCA territory.
1:31
So, even though patient presented
1:33
in the subacute period,
1:35
it's matching perfectly all the findings
1:37
with a subacute stroke.
Case - Subacute Stroke Evaluation (Case 1)
HIDEInteractive Transcript
0:01
These are images of a patient who came in with
0:04
some mental status changes and
0:07
intermittent speech changes.
0:09
And you can see this lesion characterized by
0:12
partially restricted diffusion.
0:14
DWI, bright.
0:15
ADC, dark.
0:16
Part of it's sort of isointense on ADC images.
0:20
When you're comparing it with the FLAIR
0:21
abnormality and the sort of wedge
0:23
shape defect on FLAIR,
0:26
that's a little bit bigger than the DWI and ADC
0:28
because, as you can see,
0:29
some parts of this are already
0:30
pseudo normalized in ADC.
0:32
So, it kind of looks like a subacute infarct.
0:35
But let's keep inspecting more
0:37
because it could be some funny tumor.
0:39
And you can see these little
0:40
areas of petechial hemorrhage,
0:42
which would be hemorrhagic infarction 1,
0:44
according to ECA.
0:46
In the area of the restrictive diffusion,
0:49
we also gave contrast,
0:51
and you can see on this contrast
0:53
enhanced scan in that region,
0:55
there's gyroform enhancement throughout that region,
1:00
and we can follow that all the way up.
1:02
We can also look at that in another plane.
1:05
And again,
1:05
you can see the enhancements gyroform,
1:07
which is very classic of both arterial
1:10
and venous infarction.
1:11
This is in an MCA distribution.
1:13
So, we're kind of thinking that this is
1:15
a subacute infarction with swelling,
1:16
gyroform enhancement and petechial hemorrhage.
1:19
And then, we'll take a look at the MRA.
1:22
And you can see on the MRA,
1:24
there's stenosis near the MCA bifurcation.
1:27
There's relatively poor flow related
1:29
enhancement in the MCA territory.
1:31
So, even though patient presented
1:33
in the subacute period,
1:35
it's matching perfectly all the findings
1:37
with a subacute stroke.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Neuroradiology
Neuro
MRI
MRA
Head and Neck
Brain
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