Radiology MRI

  Case: Chronic Subdural Hematoma (MRI Characteristics) Imaging Modality:   MRI Brain   Sequences Provided:   Axial T2, Axial FLAIR, Coronal FLAIR, Sagittal (with localization arrows) Radiologic Findings:   The MRI demonstrates a left-sided, crescentic extra-axial fluid collection overlying the cerebral convexity, measuring approximately 7.2 mm in maximum thickness. A critical educational point is best appreciated on the initial   axial T2-weighted image : note the medial displacement and compression of the underlying subarachnoid space. You can clearly visualize the small cortical veins situated at the inner margin of the fluid collection, right against the displaced cortex. This "cortical vein sign" confirms the fluid is entirely within the subdural space, pushing the arachnoid membrane and subarachnoid space inward. When cross-referencing with the   FLAIR sequences   (axial, coronal, and sagittal), the collection does not suppress completely li...

  Case: Spinal Extradural Arachnoid Cyst (Nabors Type IA) Imaging Modality:   MRI Thoracolumbar Spine   Sequences Provided:   Sagittal T2, Axial T2, Sagittal T1 Radiologic Findings:   The MRI demonstrates a well-circumscribed, unilocular cystic lesion located within the posterior extradural space of the lower thoracic spine, at approximately the T11-T12 level. The lesion follows cerebrospinal fluid (CSF) signal characteristics across all pulse sequences, appearing uniformly hyperintense on T2-weighted images and hypointense on T1-weighted images. Spanning approximately 24 mm in craniocaudal dimension, the cyst exerts focal mass effect upon the thecal sac. It causes significant anterior displacement and compression of the distal spinal cord. The axial T2-weighted sequence confirms its posterolateral extradural position, illustrating the resultant flattening of the dural sac. There are no internal septations, complex features, or solid components visible. Impressi...

  In this video I show how we score dementia patients according to the Dementia Protocol. What we look at and how we describe it.   

Wellcome to my new YouTube channel called RP Radiology - Radiant Pixels dedicated to radiology learning.  First case titled  Cavernoma  shows correlation of incidental finding of a Cavernoma on CT Brain with confirmation of this diagnosis on MRI.  See also my previous posts on this subject: Cavernoma - Cavernous Angioma Pontine Cavernoma Multiple Cavernomas  

A patient with a known family history of MELAS (Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) presented with new neurological symptoms. On initial CT brain, there was a low-attenuation lesion in the right frontoparietal centrum semiovale that resembled a lacunar infarct. However, a follow-up MRI revealed: • The lesion was hyperintense on DWI, but without corresponding ADC restriction — this indicates vasogenic edema rather than cytotoxic edema, which is not typical for an acute infarction. • There was also evidence of old cortical volume loss in the same hemisphere, in the temporal lobe suggesting previous stroke-like episodes. • Importantly, these lesions do not follow a specific vascular territory. This pattern — recurrent, stroke-like lesions that spare strict vascular distributions and lack classic infarct diffusion restriction — is characteristic of MELAS. The underlying cause is mitochondrial dysfunction leading to metabolic failure and l...

Sometimes it happens that you get the last vertebral body number placement wrong or you do not double click with correct speed. Tips: You can remove the last marked vertebral body using BACKSPACE key on your keyboard. This way you do not have to start over. But the numbers have to be still active showing white square. See example of this T4 that can be removed by using BACKSPACE.