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 62-year-old male
0:03
who had right sided weakness.
0:05
And initially, he had a non-contrast CT,
0:07
and there's no hemorrhage.
0:09
It looks pretty normal.
0:10
Maybe there's some
0:12
minimal, if any,
0:14
abnormality in the left basal ganglia,
0:17
and don't really see a hyperdense vessel sign.
0:22
And then, he got a CTA.
0:25
And you can see on the CTA that there's
0:28
a cut off of this large M2 branch,
0:31
and they're pretty good collaterals.
0:33
So, that was the CTA.
0:34
So next, he got an MR.
0:37
And you can see on the DWI images
0:41
that there's a very small infarct involving the left
0:44
basal ganglia and corona radiata.
0:48
And it's dark on ABC images,
0:52
as you'd expect with an acute infarct.
0:54
On the FLAIR images,
0:57
there's really not much FLAIR abnormality
0:59
because it's very early.
1:00
There's no breakdown of blood-brain barrier,
1:03
and then there's some hyperintensity in vessels
1:06
all the way up over the cortex,
1:08
suggesting that there's maybe good collateralization.
1:12
So here's the DWI,
1:13
and then this is the transit time map,
1:17
the T max map that's thresholded,
1:19
and you can see there's a big mismatch between
1:21
the DWI and the delay in the transit time,
1:25
which is basically most of the superior division
1:28
of the left MCA.
1:30
Som MCA, M2 embolus,
1:34
big core penumbra mismatch,
1:37
good collaterals.
1:39
And so, this patient did go to thrombolysis.
1:43
So, here's the follow up DWI.
1:46
And you can see that here's the initial infarct,
1:50
and there's a little bit of extension
1:54
into the penumbra,
1:55
but most of it was spared with the
1:57
patient having thrombectomy.
Case - MR Perfusion Target Mismatch (Good Collaterals)
HIDEInteractive Transcript
0:00
These are images of a 62-year-old male
0:03
who had right sided weakness.
0:05
And initially, he had a non-contrast CT,
0:07
and there's no hemorrhage.
0:09
It looks pretty normal.
0:10
Maybe there's some
0:12
minimal, if any,
0:14
abnormality in the left basal ganglia,
0:17
and don't really see a hyperdense vessel sign.
0:22
And then, he got a CTA.
0:25
And you can see on the CTA that there's
0:28
a cut off of this large M2 branch,
0:31
and they're pretty good collaterals.
0:33
So, that was the CTA.
0:34
So next, he got an MR.
0:37
And you can see on the DWI images
0:41
that there's a very small infarct involving the left
0:44
basal ganglia and corona radiata.
0:48
And it's dark on ABC images,
0:52
as you'd expect with an acute infarct.
0:54
On the FLAIR images,
0:57
there's really not much FLAIR abnormality
0:59
because it's very early.
1:00
There's no breakdown of blood-brain barrier,
1:03
and then there's some hyperintensity in vessels
1:06
all the way up over the cortex,
1:08
suggesting that there's maybe good collateralization.
1:12
So here's the DWI,
1:13
and then this is the transit time map,
1:17
the T max map that's thresholded,
1:19
and you can see there's a big mismatch between
1:21
the DWI and the delay in the transit time,
1:25
which is basically most of the superior division
1:28
of the left MCA.
1:30
Som MCA, M2 embolus,
1:34
big core penumbra mismatch,
1:37
good collaterals.
1:39
And so, this patient did go to thrombolysis.
1:43
So, here's the follow up DWI.
1:46
And you can see that here's the initial infarct,
1:50
and there's a little bit of extension
1:54
into the penumbra,
1:55
but most of it was spared with the
1:57
patient having thrombectomy.
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
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