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
These are images of a 91-year-old female with
0:03
left-sided weakness and you can see there's
0:07
hypodensity in the right basal ganglia and
0:10
going up into the corona radiata a little bit.
0:13
MCA stem looks pretty good.
0:15
I don't see an obvious hyperdense vessel sign.
0:18
So, let's take a look at the CTA.
0:22
So when we look at the CTA MIP, we can see
0:24
that there is in fact an MCA cutoff.
0:27
There's good collateralization in the right MCA territory.
0:31
Not complete, though.
0:31
It's not quite as good as the other side.
0:34
So the patient then got perfusion
0:36
images and diffusion images.
0:39
And we can see on the diffusion map,
0:43
that there's really just a small infarct
0:46
involving the basal ganglia and the corona radiata.
0:49
But here's the ASL image and you can see that
0:52
there's a much larger area on
0:54
the ASL compared to the DWI.
0:57
So, it looks like there's a bit of tissue at
1:01
risk and there's also, you'll notice this
1:04
abnormality in the ACA territory as well.
1:06
And then if you go back and look at the CTA,
1:09
you can see there's a cutoff of one
1:11
of the ACA branches right here.
1:13
So, large area of tissue at risk.
1:15
They maximize therapy,
1:18
the patient had a follow-up CT.
1:21
And you can see that this ACA territory
1:25
did infarct and part of the MCA territory infarcted,
1:28
but lower down, there was some sparing.
1:30
So, just an example of ASL showing tissue at
1:34
risk and progression of the infarct
1:37
despite of maximum medical therapy.
Case - ASL Showing Tissue at Risk
HIDEInteractive Transcript
0:00
These are images of a 91-year-old female with
0:03
left-sided weakness and you can see there's
0:07
hypodensity in the right basal ganglia and
0:10
going up into the corona radiata a little bit.
0:13
MCA stem looks pretty good.
0:15
I don't see an obvious hyperdense vessel sign.
0:18
So, let's take a look at the CTA.
0:22
So when we look at the CTA MIP, we can see
0:24
that there is in fact an MCA cutoff.
0:27
There's good collateralization in the right MCA territory.
0:31
Not complete, though.
0:31
It's not quite as good as the other side.
0:34
So the patient then got perfusion
0:36
images and diffusion images.
0:39
And we can see on the diffusion map,
0:43
that there's really just a small infarct
0:46
involving the basal ganglia and the corona radiata.
0:49
But here's the ASL image and you can see that
0:52
there's a much larger area on
0:54
the ASL compared to the DWI.
0:57
So, it looks like there's a bit of tissue at
1:01
risk and there's also, you'll notice this
1:04
abnormality in the ACA territory as well.
1:06
And then if you go back and look at the CTA,
1:09
you can see there's a cutoff of one
1:11
of the ACA branches right here.
1:13
So, large area of tissue at risk.
1:15
They maximize therapy,
1:18
the patient had a follow-up CT.
1:21
And you can see that this ACA territory
1:25
did infarct and part of the MCA territory infarcted,
1:28
but lower down, there was some sparing.
1:30
So, just an example of ASL showing tissue at
1:34
risk and progression of the infarct
1:37
despite of maximum medical therapy.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Neuroradiology
Neuro
MRI
Head and Neck
CTA
CT
Brain
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