Posts

Evolution of Hemorrhagic Infarctions on MRI

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  Evolution of Hemorrhagic Infarctions on MRI Welcome to another intriguing radiology case study. In our latest release on the Radiant Pixels YouTube channel, we dive into a comparative MRI analysis of an 80-year-old patient, examining scans taken five months apart. This case provides a fantastic look at the evolution of subacute infarctions and the often-perplexing behavior of contrast-enhancing areas over time. The Initial Findings and the Mystery Enhancement The baseline exam reveals distinct areas of tissue loss and gliosis, accompanied by contrast enhancement in the medial parts of the right occipital lobe. We also observe similar, smaller contrast-enhancing areas in the right lateral frontal lobe, specifically at the level of the inferior frontal gyrus. The initial radiological report strongly suggested these locations were indicative of subacute to old infarctions within the posterior cerebral artery territory. However, the persistent contrast enhancement presented a specif...
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New Video Case on Radiat Pixels: Radiation-Induced Cavernous Malformation

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  I have just uploaded a new video case to the   Radiat Pixels   YouTube channel, highlighting a fascinating and critical late complication of oncological treatment that every radiologist should keep on their radar. Case Overview In this week's video, we review the neuroimaging follow-up of a 33-year-old patient. The clinical timeline is key here: this patient underwent surgical resection and subsequent therapy for a medulloblastoma during childhood. Crucially, a follow-up control exam performed when the patient was 19 years old was completely clear, showing no signs of tumor recurrence and no vascular abnormalities. Now, at 33 years of age, the latest follow-up imaging reveals the distinct development of a new cavernous malformation. The Core Teaching Point The primary takeaway from this case is a vital reminder for long-term follow-up imaging:   Cavernomas can be radiation-induced. Radiation-induced cavernous malformations (RICMs) are a well-documented, delayed com...
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MVNT - Multinodular and Vacuolating Neuronal Tumour

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  New on Radiant Pixels : Spotting an MVNT in a Suspected Epilepsy Case Welcome to   Radiant Pixels , my brand-new YouTube channel dedicated to fascinating radiological cases and imaging insights! In our latest video, we are diving deep into a compelling neuroimaging workup of an adult patient being investigated for a possible epilepsy focus. The Case Breakdown Initial investigations started with a standard CT scan, which was entirely negative. However, the MRI painted a much more detailed and intriguing picture. During the read, we isolated a very specific lesion with the following characteristics: Location:   Juxtacortically adjacent to the right gyrus cinguli. Morphology:   A distinct, micro-bubbly and nodular appearance. Edema:   Absolutely no perifocal edema present. Vascularity & Enhancement:   No pathological vessels and zero contrast enhancement. The Diagnosis For radiologists, these specific imaging hallmarks—particularly the juxtacortical bubb...
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Pituitary Macroadenoma - Radiant Pixels video

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Welcome back to the blog! I am expanding the ways we explore radiology together with the launch of my new YouTube channel,   Radiant Pixels . To kick things off, the latest video features a classic but highly educational case of a   Pituitary Macroadenoma   (a benign tumor measuring >1 cm). In this visual walkthrough, we focus on the crucial anatomical landmarks and how to systematically assess the tumor's boundaries on MRI. The main teaching points covered in the video include: The Optic Chiasm:   Assessing for superior extension and chiasmal compression, which is vital for correlating with visual field deficits like bitemporal hemianopsia. The Cavernous Sinus:   Evaluating the degree of lateral invasion and understanding the implications for the internal carotid artery and adjacent cranial nerves. Normal Pituitary Remnants:   Identifying the displaced, compressed normal gland tissue to properly differentiate the adenoma from other sellar and parasellar...
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Chronic Subdural Hematoma: A Deeper Dive into MRI Sequences and Subdural Anatomy

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  Following our previous discussion on the clinical presentation of Chronic Subdural Hematoma (cSDH) and its appearance on CT, today we're going a step further. We'll utilize specific MRI sequences and CT correlation to gain a more detailed understanding of the signal characteristics of cSDH and, crucially, to properly visualize the anatomy of the subdural space, which is typically just a potential space but becomes strikingly apparent in this pathology. All the images we'll examine today are from the same patient, providing a comprehensive, multi-modal overview of their diagnosis. Expanding the Potential Space: The T1 Signal Characteristics We begin our detailed look with an enlarged axial T1-weighted image. T1 sequences are excellent for anatomical detail and can sometimes help characterize fluid based on its protein content and hemorrhagic degradation products. In this image, you can clearly see a fluid collection expanding along the cerebral convexity. The key takeaway ...
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The Lasting Imprint of Poliovirus on the Spine and Musculature

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  Radiology Case Review: The Lasting Imprint of Poliovirus on the Spine and Musculature While widespread vaccination efforts have made acute poliomyelitis a rare encounter in modern clinical practice, radiologists still frequently observe the chronic, lasting footprints of the virus in adult patients. Today, we are reviewing a fascinating and historically significant MRI case that beautifully illustrates the long-term sequelae of polio on both the central nervous system and the musculoskeletal system. The poliovirus has a notorious affinity for the lower motor neurons, specifically targeting the anterior horn cells of the spinal cord. Decades after the initial infection, the resultant damage presents with a very characteristic set of imaging findings. Let’s break down the key features visible in this patient’s scans. 1. Symmetrical Anterior Signal Changes in the Spinal Cord Looking at the axial T2-weighted images of the cervical spine, the pathophysiology of the virus is strikingly...
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Chronic Subdural Hematoma - MRI Characteristics

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  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...
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