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
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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