Radiology MRI

Incidental, benign finding on CT showing cyst in the trajectory of the incisive canal representing Incisive Canal Cyst , aka Nasopalatine Duct Cyst . Clues here are well defined borders and location. Developmental anomaly.

Unfortunately it is very popular in Sweden to use small tobacco bags placed under the upper lip - locally known as Snus . When I saw for the first time a nice Swedish lady placing such tobacco bag under her lip during a meeting - I was shocked with disgust. Note snus bag under the lip as "incidental finding" on the above CT. This case expands "my collection" of various objects found in patient's mouth. You might check my previous:  Chewing Gum on CT and  Candy Under the Tongue on CT . 

Patient presented with expressive dysphasia . MRI shows acute infarct in Broca's Area in the left inferior frontal gyrus that is responsible for speech production. Note high signal on DWI, low on corresponding ADC as well as signal changes on T2 and coronal FLAIR.

I have already mentioned  CSF Leakage - Intracranial Hypotension and  Intracranial Hypotension before. Here I would like to present a simple and effective MRI protocol to show the CSF leakage. The clue is to use heavy T2 weighted sequence with thin slice, good resolution and what is most important - fat saturation. We want to get rid of epidural fat. Note on the images above the epidural CSF dorsally to dural sack that extends from cervical to low thoracic level. Sagittal projections show extend of the leakage, while tranversal images show more detail anatomy. This investigation was performed on Siemens Trio Tim 3T machine with the same sequence in two projections: - sag: t2_spc_sag_p3_iso_384_myelo Nex 2 Slice 0.8 mm TR: 1500 TE: 224 Flip angle: 110 - tra: t2_spc_tra_p2_iso_320_myelo Nex 2 Slice 1 mm TR: 1500 TE: 224 Flip angle: 110 For the location of the tranversal sections it is wise to ask your technicians to request radiologist supervision...

This case shows typical findings in a patient with Tuberous Sclerosis . Note cortical and subcortical tubers on transversal T2 and coronal FLAIR as well as contrast enhancing  Giant Cell Astrocytoma in the left foramen Monroe region. Also note subependymal nodules  that are both calcified (see CT and T2 GRE) and showing contrast enhancement (arrowheads). Above findings can present with variable expression in different patients.